Helicobacter pylori and oral–gut microbiome: clinical implications

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Elghannam M.T.; Hassanien M.H.; Ameen Y.A.; Turky E.A.; ELattar G.M.; ELRay A.A.; ELTalkawy M.D.

Journal: Infection

Publisher: Springer Science and Business Media Deutschland GmbH

Publication Date: 2 November 2023

Volume / Issue: Volume 52 / Issue 2

Pages: 289–300

ISSN: 3008126

DOI: 10.1007/s15010-023-02115-7

Scopus: View on Scopus

PubMed: 37917397

Document Type: Review

Access: All Open Access; Hybrid Gold Open Access

Authors and Affiliations

Elghannam M.T., Hepatogastroenterology Department, Theodor Bilharz Research Institute, Giza, Egypt; Hassanien M.H., Hepatogastroenterology Department, Theodor Bilharz Research Institute, Giza, Egypt; Ameen Y.A., Hepatogastroenterology Department, Theodor Bilharz Research Institute, Giza, Egypt; Turky E.A., Hepatogastroenterology Department, Theodor Bilharz Research Institute, Giza, Egypt; ELattar G.M., Hepatogastroenterology Department, Theodor Bilharz Research Institute, Giza, Egypt; ELRay A.A., Hepatogastroenterology Department, Theodor Bilharz Research Institute, Giza, Egypt; ELTalkawy M.D., Hepatogastroenterology Department, Theodor Bilharz Research Institute, Giza, Egypt

Abstract

More than half of the world’s population are colonized with H. pylori; however, the prevalence varies geographically with the highest incidence in Africa. H. pylori is probably a commensal organism that has been associated with the development of gastritis, ulcers, and gastric cancer. H. pylori alone is most probably not enough for the development of gastric carcinoma, but evidence for its association with the disease is high and has, therefore, been classified by the International Agency for Research on Cancer as a Class 1 carcinogen. Bacteroidetes and Fusobacteria positively coexisted during H. pylori infection along the oral–gut axis. The eradication therapy required to treat H. pylori infection can also have detrimental consequences for the gut microbiota, leading to a decreased alpha diversity. Therefore, therapy regimens integrated with probiotics may abolish the negative effects of antibiotic therapy on the gut microbiota. These eradication therapies combined with probiotics have also higher rates of eradication, when compared to standard treatments, and are associated with reduced side effects, improving the patient’s compliance. The eradication therapy not only affects gut microbiome but also affects the oral microbiome with robust predominance of harmful bacteria. However, there have been reports of a protective role of H. pylori in Barrett’s esophagus, esophageal adenocarcinoma, eosinophilic esophagitis, IBD, asthma, and even multiple sclerosis. Therefore, eradication therapy should be carefully considered, and test to treat policy should be tailored to specific communities especially in highly endemic areas. Supplementation of probiotics, prebiotics, herbals, and microbial metabolites to reduce the negative effects of eradication therapy should be considered. After failure of many eradication attempts, the benefits of H. pylori eradication should be carefully balanced against the risk of adverse effects especially in the elderly, persons with frailty, and intolerance to antibiotics. © The Author(s) 2023.

Keywords

Clinical implications; Gastric carcinoma; H. pylori infection; Oral and gut microbiota; Peptic ulcer disease; Aged; Anti-Bacterial Agents; Gastritis; Gastrointestinal Microbiome; Helicobacter Infections; Helicobacter pylori; Humans; antibiotic agent; herbaceous agent; microbial products not classified elsewhere; prebiotic agent; probiotic agent; antiinfective agent; antibiotic therapy; asthma; bacterial microbiome; bacterial phenomena and functions; Barrett esophagus; clinical feature; disease association; eosinophilic esophagitis; eradication therapy; esophageal adenocarcinoma; Helicobacter infection; human; inflammatory bowel disease; intestine flora; microbial community; mouth flora; multiple sclerosis; nonhuman; Review; stomach carcinoma; stomach ulcer; supplementation; microbiology

Citation Information

Scopus Citations: 35

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