Published online Jul 16, 2023. doi: 10.12998/wjcc.v11.i20.4740
Peer-review started: March 22, 2023
First decision: April 8, 2023
Revised: June 7, 2023
Accepted: June 21, 2023
Article in press: June 21, 2023
Published online: July 16, 2023
Processing time: 111 Days and 20.8 Hours
The article discusses various approaches for probiotic treatment of Helicobacter pylori (H. pylori) infection: Probiotics as an adjuvant treatment in the standard eradication therapy; probiotic strains as a monotherapy; and autoprobiotics as a monotherapy. Autoprobiotics refer to indigenous bifidobacteria, lactobacilli, or enterococci isolated from a specific individual, intended to restore his/her microbiota and improve his/her health. The potential mechanisms of probiotic action against H. pylori include correction of the gut microbiota, immunological effects (enhancement of humoral and cellular immunity, and reduction of oxidative stress), direct antagonistic effects against H. pylori (such as colonization resistance and bacteriocin synthesis), and stimulation of local immunological protection (strengthening of the mucous protective barrier and reduction of gastric mucosa inflammation). The incorporation of probiotics into comprehensive eradication therapy shows promise in optimizing the treatment of H. pylori infection. Probiotics can enhance the eradication rates of H. pylori, reduce the occurrence and severity of side effects, and improve patient compliance. Probiotic or autoprobiotic monotherapy can be considered as an alternative treatment approach in cases of allergic reactions and insufficient effectiveness of antibiotics. We recommend including probiotics as adjunctive medications in anti-H. pylori regimens. However, further randomized multicenter studies are necessary to investigate the effects of probiotics and autoprobiotics against H. pylori, in order to gain a better understanding of their mechanisms of action.
Core Tip: The usage of probiotics in complex eradication therapy holds promise for optimizing the treatment of Helicobacter pylori (H. pylori) infection. Probiotics have the potential to enhance the eradication rate of H. pylori, reduce the frequency and severity of side effects, and improve patient compliance. Probiotic and autoprobiotic monotherapies are viable alternatives in cases of allergic reactions or adverse effects caused by antibiotics, owing to their direct antagonistic effect on H. pylori. However, conducting new randomized multicenter studies is necessary to investigate the intricate effects of probiotics and autoprobiotics against H. pylori infection, with the aim of gaining a better understanding of their mechanisms of action.