In vivo Inhibition of Helicobacter pylori through Probiotics and Gastrointestinal Commensals: A Critical Review

Background: Helicobacter pylori eradication is increasingly challenged, due to high antibiotic resistance rates in H. pylori and treatment failure. Consequently, new treatment regimens are needed. Probiotic and gastrointestinal bacteria exert anti-H. pylori activity in vivo, thus being potential add-on candidates for future eradication strategies. Summary: In this review, we summarised the currently available literature for in vivo inhibition of H. pylori. Included studies address anti-H. pylori effects in mouse and rat models caused by potentially beneficial bacteria. Research on literature was further extended to clinical eradication studies in humans. Several bacterial strains, mainly belonging to the Lactobacillus genus, inhibited H. pylori in vivo. In animal studies, probiotic bacteria and commensals reduced H. pylori colonisation and the inflammatory response. Certain probiotic species reduce H. pylori colonisation in humans. Key Messages: Probiotic and gastrointestinal commensals are beneficial in H. pylori eradication therapy. Their current role is the reduction of adverse events and H. pylori load.