Helicobacter pylori (H. pylori) is a spiral-shaped bacterium attached to or just above the gastric mucosa. The organism can persist in the stomach indefinitely and may not cause clinical illness many years after its infection. H. pylori is associated with the development of gastrointestinal disorders as chronic gastritis, peptic ulcer, and gastric adenocarcinoma. H. pylori is also involved in the development of other extra-gastric disorders such as mucosa-associated lymphoid tissue lymphoma (MALT), idiopathic thrombocytopenic purpura, vitamin B12 deficiency, and iron deficiency. H. pylori gastric infection is one of the most prevalent infectious diseases worldwide, with an estimate of 40%-50% of the world population.
Currently, numerous antibiotic-based therapies are available. However, these therapies have several inherent problems, including the appearance of resistance to the antibiotics used and associated adverse effects, the risk of re-infection and the high cost of antibiotic therapy.
Probiotics represent a low-cost, large-scale alternative solution to prevent or decrease H. pylori colonization. Several mechanisms have been hypothesized based on in vitro studies of host intestinal epithelial or immune cell responses to probiotic strains. Probiotic bacteria can inhibit H. pylori by either immunological or non-immunological mechanisms.
Firstly, by taking probiotics, this first line of defense could be stronger due to the production of antimicrobial substances competing with H. pylori for adhesion receptors, stimulating mucin production, and stabilizing the gut mucosal barrier. Secondly, Probiotics may inhibit H. pylori growth by secreting short-chain fatty acids and antibacterial substances. Thirdly, there are several possible mechanisms by which probiotic bacteria can inhibit the adhesion of H. pylori. Finally, probiotics could modify the immunologic response by modulating anti-inflammatory cytokine secretion, resulting in a reduction of gastric activity and inflammation.
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