Effect of Probiotic‐Assisted Eradication of <i>cagA</i>+/<i>vacA s1m1 Helicobacter pylori</i> on Intestinal Flora
Chenxi He, Fanting Kong, Xiukun Chai, Chunyan Zou, Xinying Zhu, Dong-qiang Zhao
Abstract
Objective . We attempted to evaluate the effects of probiotic‐assisted eradication of cytotoxin ‐ associated gene A ( cagA )+/ vacuolating cytotoxin A ( vacA ) s1m1 Helicobacter pylori ( H. pylori ) on the intestinal flora, inflammatory factors, and clinical outcomes. Methods . A total of 180 patients with cagA +/ vacA s1m1 H . pylori were randomly divided into two groups. Group A was treated with bismuth quadruple therapy (BQT). Group B was treated with S. boulardii in addition to BQT. The distribution of intestinal flora, serum interleukin‐8 (IL‐8), IL‐17, tumor necrosis factor‐ α (TNF‐ α ) levels, recovery time of clinical symptoms, total effective rate of clinical symptoms, H. pylori eradication rate, and adverse reactions were observed. Results . 2 weeks after treatment, the contents of Bifidobacterium , Bacteroides , and Lactobacillus in the intestinal tract of Group A decreased, while the amounts of Enterococcus and Enterobacter increased. In Group B, the contents of Bifidobacterium , Bacteroides , and Lactobacillus increased, while the amounts of Enterococcus and Enterobacter did not change significantly. Moreover, the trend of this flora change was still present at 4 weeks after treatment. Compared with Group A, Group B had lower IL‐8, IL‐17, and TNF‐ α levels, shorter recovery time of clinical symptoms, higher overall efficiency of clinical symptoms, and lower occurrence of adverse reactions. The eradication rate did not differ significantly between the two groups. Conclusion . BQT can lead to intestinal flora disorders in cagA +/ vacA s1m1 H. pylori patients. S. boulardii can improve the distribution of intestinal flora, downregulate immune‐inflammatory mediators, and modify clinical symptoms in patients.