In vivo inhibition of Helicobacter pylori through probiotics and gastrointestinal commensals: a critical review

Introduction: 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. Methods: In this review we summarized 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. Results: 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 lead to a decrease of H. pylori colonisation. However, H. pylori eradication with current probiotic therapy is not obtained. Conclusion: Probiotic and gastrointestinal commensals are beneficial in H. pylori eradication therapy. Their current role is the reduction of adverse events and H. pylori load.