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Gastric microbiota and probiotics opportunities in helicobacter pylori eradication in children


Gastroenterology & Hepatology: Open Access
Elena A Kornienko,1 Natalia I Parolova,1 Sergey V. Ivanov,2 Dmitry S Polev,3 Pavel A Zykin,3 Yulia DKondratenko,3 Mikhail M Zakharchenko4

Abstract

H. pylori infection changes the composition of gastric microbiota, but data in children are scared. Probiotics can improve the results of eradication therapy, but as long as adjuvant therapy. 
The aim of our study to assess effectiveness of monotherapy and adjuvant therapy of probiotic L. reuteri DSMZ17648 (Lr) in   H. pylori (+) children.
 
Material and methods: In 103 patients 9 to 17 years, a double-blind, randomized, placebo-controlled study of the effectiveness of L. reuteri DSMZ17648 (Lr) was performed both as monotherapy and adjuvant to eradication therapy (omeprazole + amoxicillin + metronidazole + bismuth- OAMB for 10days), the Lr course in subgroup A lasted for 28days, in subgroup B for 56days. The control ??-status was performed twice: before the treatment and after it (on 56 day) - by endoscopy, histology, Rapid Urease Test (RUT), Ammonia Breath Test (ABT), H. pylori count in the biopsy, inflammatory and atrophic indices were counted. In 8 H. pylori (+) and 8 H. pylori (-) children, sequencing of 16S-rRNA microbiota in biopsies of gastric mucosa was carried out for surrounding microbiota assessment.  
 
Results: H. pylori decreased microbial diversity associated with inflammation and focal mucosal atrophy. H. pylori eradication was achieved on Lr monotherapy in 50% after 28 and 60% after 56days, on adjuvant Lr therapy - 60% after 28 and 77.8% after 56days, in placebo group – 68.8% after 28 and 56days. Clinical manifestation, inflammatory and atrophic changes during Lr treatment significantly and reliably decreased. 
 
Conclusion: Lr monotherapy is comparable in effectiveness to a standard eradication therapy
 

Keywords

H. pylori, non-Helicobacter gastric microbiota, probiotics, L. reuteri, microorganisms, atrophy, gastric microbiota, growth factors, gastroenterology

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