The efficacy of Lactobacillus acidophilus and rhamnosus in the reduction of bacterial load of <i>Helicobacter pylori</i> and modification of gut microbiota—a double‐blind, placebo‐controlled, randomized trial
Mei‐Jyh Chen, Chieh‐Chang Chen, Yu‐Chun Huang, Chieh‐Chih Tseng, Jing‐Ting Hsu, Lin Yi-fen, Yu‐Jen Fang, Ming‐Shiang Wu, Jyh‐Ming Liou
Abstract
Abstract Background Probiotics may alter the gut microbiota and may reduce antibiotic‐related dysbiosis after H . pylori eradication. However, whether probiotics are effective in reducing the bacterial load of H . pylori and modifying the gut microbiota remains unknown. We aimed to assess the efficacy of Lactobacillus acidophilus and Lactobacillus rhamnosus in reducing the bacterial load of H . pylori and modifying the gut microbiota. Materials and methods In this double‐blind, randomized, placebo‐controlled trial, we recruited 40 adult subjects with moderate to high bacterial loads of H . pylori , defined as a mean delta over baseline (DOB) value of the 13 C‐urea breath test ( 13 C‐UBT) of 10 or greater every 4 days 6 times. Eligible subjects were randomized in a 1:1 ratio to receive either probiotics containing Lactobacillus acidophilus and Lactobacillus rhamnosus or placebo twice daily for 4 weeks. 13 C‐UBT was measured weekly from the beginning of treatment to 2 weeks after treatment. Amplification of the V3 and V4 hypervariable regions of the 16S rRNA was performed for fecal microbiota. Results A total of 40 subjects were randomized to receive probiotics or placebo. The DOB value was significantly lower in the probiotic group than in the placebo group after 4 weeks of treatment (26.0 vs. 18.5, p = .045). The DOB value was significantly reduced compared to that at baseline in the probiotic group (18.5 vs. 26.7, p = .001) but not in the placebo group (26.0 vs. 25.0, p = .648). However, the eradication rate for H . pylori was 0% in both groups. There was no significant difference in the DOB values between the two groups 1 and 2 weeks after discontinuation of the probiotics. There were also no significant changes observed in the α‐diversity and β‐diversity at week 4 compared to baseline in the probiotic group ( p = .77 and 0.91) and the placebo group ( p = .26 and 0.67). Conclusions Although the use of Lactobacillus acidophilus and Lactobacillus rhamnosus may reduce the bacterial load of H . pylori , there were no significant changes in the composition of gut microbiota. This trial is registered with ClinicalTrials.gov, NCT02725138.