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      Probiotics and autoprobiotics for treatment of Helicobacter pylori infection

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          Abstract

          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.

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          Most cited references90

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          Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report.

          Important progress has been made in the management of Helicobacter pylori infection and in this fifth edition of the Maastricht Consensus Report, key aspects related to the clinical role of H. pylori were re-evaluated in 2015. In the Maastricht V/Florence Consensus Conference, 43 experts from 24 countries examined new data related to H. pylori in five subdivided workshops: (1) Indications/Associations, (2) Diagnosis, (3) Treatment, (4) Prevention/Public Health, (5) H. pylori and the Gastric Microbiota. The results of the individual workshops were presented to a final consensus voting that included all participants. Recommendations are provided on the basis of the best available evidence and relevance to the management of H. pylori infection in the various clinical scenarios.
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            The Toronto Consensus for the Treatment of Helicobacter pylori Infection in Adults.

            Helicobacter pylori infection is increasingly difficult to treat. The purpose of these consensus statements is to provide a review of the literature and specific, updated recommendations for eradication therapy in adults.
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              The Genus Enterococcus : Between Probiotic Potential and Safety Concerns—An Update

              A considerable number of strains belonging to different species of Enterococcus are highly competitive due to their resistance to wide range of pH and temperature. Their competitiveness is also owed to their ability to produce bacteriocins recognized for their wide-range effectiveness on pathogenic and spoilage bacteria. Enterococcal bacteriocins have attracted great research interest as natural antimicrobial agents in the food industry, and as a potential drug candidate for replacing antibiotics in order to treat multiple drugs resistance pathogens. However, the prevalence of virulence factors and antibiotic-resistance genes and the ability to cause disease could compromise their application in food, human and animal health. From the current regulatory point of view, the genus Enterococcus is neither recommended for the QPS list nor have GRAS status. Although recent advances in molecular biology and the recommended methods for the safety evaluation of Enterococcus strains allowed the distinction between commensal and clinical clades, development of highly adapted methods and legislations are still required. In the present review, we evaluate some aspects of Enterococcus spp. related to their probiotic properties and safety concerns as well as the current and potential application in food systems and treatment of infections. The regulatory status of commensal Enterococcus candidates for food, feed, probiotic use, and recommended methods to assess and ensure their safety are also discussed.
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                Author and article information

                Contributors
                Journal
                World J Clin Cases
                WJCC
                World Journal of Clinical Cases
                Baishideng Publishing Group Inc
                2307-8960
                16 July 2023
                16 July 2023
                : 11
                : 20
                : 4740-4751
                Affiliations
                Department of Molecular Microbiology, Institute of Experimental Medicine, St. Petersburg 197376, Russia
                Internal Diseases Department of Stomatological Faculty, Pavlov First St-Petersburg State Medical University, St. Petersburg 197022, Russia
                Laboratory of Medical and Social Pediatric Problems, St-Petersburg State Pediatric Medical University, St. Petersburg 194100, Russia. baryshnikova_nv@ 123456mail.ru
                Clinical Department, Institute of Experimental Medicine, St. Petersburg 197376, Russia
                Department of Molecular Microbiology, Institute of Experimental Medicine, St. Petersburg 197376, Russia
                Internal Diseases Department of Stomatological Faculty, Pavlov First St-Petersburg State Medical University, St. Petersburg 197022, Russia
                Department of Faculty Therapy Named After V.A. Valdman, St-Petersburg State Pediatric Medical University, St. Petersburg 194100, Russia
                Department of Molecular Microbiology, Institute of Experimental Medicine, St. Petersburg 197376, Russia
                Author notes

                Author contributions: Uspenskiy YP, Suvorov AN, Baryshnikova NV, Ilina AS, and Ermolenko EI contributed equally to this work; Uspenskiy YP and Suvorov AN designed the research; Baryshnikova NV, Ilina AS, and Ermolenko EI performed the research; Baryshnikova NV, Ilina AS, and Ermolenko EI contributed new reagents/analytic tools; Uspenskiy YP and Suvorov AN analyzed the data; Baryshnikova NV, Ilina AS, and Ermolenko EI wrote the paper; all authors have read and agreed to the published version of the manuscript.

                Corresponding author: Natalia V Baryshnikova, MD, PhD, Associate Professor, Senior Lecturer, Department of Molecular Microbiology, Institute of Experimental Medicine, Pavlova, 12A, St. Petersburg 197376, Russia. baryshnikova_nv@ 123456mail.ru

                Article
                jWJCC.v11.i20.pg4740
                10.12998/wjcc.v11.i20.4740
                10424037
                37583996
                db4417e1-77e3-4947-9eeb-fb816db7d6c1
                ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.

                This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

                History
                : 22 March 2023
                : 7 June 2023
                : 21 June 2023
                Categories
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                helicobacter pylori,probiotic,autoprobiotic,eradication,microbiota,gut,immunity

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