Lactobacillus reuteri Gastrus in treatment of Helicobacter pylori infection
The goals of this study were to investigate the role of a new probiotic preparation, Lactobacillus reuteri Gastrus, (L. reuteri DSM 17938 and L. reuteri ATCC PTA 6475) in treatment of Helicobacter pylori infection.
This was a prospective, double-blind, randomized, placebo-controlled study in 100 H. pylori-positive naïve patients. Lactobacillus reuteri Gastrus (2×10^8 Colony Forming Units) (n=50) or placebo (n=50) were given to the patients throughout the stages of this 3-phase study (pre-eradication, eradication, and follow-up). All patients underwent 13C urea breath test (13C-UBT), blood assessments of gastrin-17 (G17), endoscopy, and the Gastrointestinal Symptom Rating Scale (GSRS). Eradication was confirmed by 13C-UBT 8 weeks after the completion of therapy.
During the pre-eradication period, 13C-UBT [delta] decreased by 13% in Lactobacillus reuteri Gastrus as compared with a 4% increase in placebo (-13.2+/-34% vs. 4.3+/-27%; P<0.03). During eradication, GSRS increased significantly in placebo as compared with Lactobacillus reuteri Gastrus (6.8+/-2.9 vs. 4+/-3.1; P<0.01). Significantly less patients in Lactobacillus reuteri Gastrus, as compared with placebo, reported side effects (40.9% vs. 62.8%; P<0.04). An abnormal G17 value was found in patients receiving placebo compared with Lactobacillus reuteri Gastrus (28% vs. 12%; P<0.02). Eradication rate was 75% in Lactobacillus reuteri Gastrus and 65.9% in placebo (P=NS). Lactobacillus reuteri Gastrus increased eradication rate by 9.1% (odds ratio: 1.5).
Lactobacillus reuteri Gastrus alone is able to exert an inhibitory effect on H. pylori growth, and when administered with eradication therapy, it led to a significant reduction in antibiotic-associated side effects. Moreover, Lactobacillus reuteri Gastrus was able to decrease serum G17 levels and to (not significantly) increase the H. pylori-eradication rate.
Francavilla R, Polimeno L, Demichina A, Maurogiovanni G, Principi B, Scaccianoce G, Ierardi E, Russo F, Riezzo G, Di Leo A, Cavallo L, Francavilla A, Versalovic J. Lactobacillus reuteri strain combination in Helicobacter pylori infection: a randomized, double-blind, placebo-controlled study. J Clin Gastroenterol. 2014;48:407-413.