Comparison of clinical-metabolic efficacy of pre- and probiotics in the conducted optimized protocols of eradication therapy of Helicobacter pylori infection

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  • Authors: Butorova L.I.1, Ardatskaya M.D.2, Osadchuk M.A.1, Kadnikova N.G.3, Lukianova E.I.4, Plavnik R.G.5, Sayutina E.V.1, Topchiy T.B.2, Tuayeva E.M.1
  • Affiliations:
    1. Sechenov First Moscow State Medical University (Sechenov University)
    2. Central State Medical Academy of the President of the Russian Federation
    3. Central Clinical Hospital for Rehabilitation Treatment
    4. City Polyclinic №201
    5. ISOCARB LLC
  • Issue: Vol 92, No 4 (2020)
  • Pages: 64-69
  • Section: Original articles
  • URL: https://ter-arkhiv.ru/0040-3660/article/view/34102
  • DOI: https://doi.org/10.26442/00403660.2020.04.000647
  • Cite item

Abstract


Low patient compliance due to the development of adverse events in the form of antibiotic-associated diarrhea (AAD) is considered as the main reason for the failure of the eradication of optimized anti-Helicobacter therapy regimens. A key mechanism for the development of AAD is to reduce the number and species diversity of bacteria that form butyric acid.

Aim. The purpose of this study was to study the comparative effect on the clinical effectiveness of eradication therapy (ET) of Helicobacter pylori infection and metabolic changes in the colon microbiota of additional inclusion in the optimized treatment regimen of the combined prebiotic Zakofalk® (inulin + butyrate) with probiotics (lacto- and bifidobacteria in an amount of at least 1017 СFU).

Materials and methods. 120 patients with chronic gastroduodenal diseases and infected H. pylori were еxamined. A comparative analysis of the effect of a combined prebiotic and lacto-bifid-containing probiotics on improving the effectiveness of the optimized ET scheme and improving its tolerability, as well as on the quantitative and qualitative content of short-chain fatty acids (SFA) in feces. The success of eradication was controlled by a 13C urease breath test.

Results. According to the results of the study in randomized groups of patients, an excellent percentage of eradication (95%) was achieved in patients who performed ET with the addition of the prebiotic Zakofalk®. In the same group of patients, there was an increase in the absolute content of SFA and a significant increase in the concentration of butyric acid. In the group of patients who received ET with the addition of probiotics, an acceptable level of eradication was achieved (85.7%), but no changes in SFA were found indicating an increase in the number or activity of the butyrate-producing flora. Patients who performed ET without the addition of pre-probiotics did not achieve the «target» percentage of successful eradication (83.3%), and a significant quantitative decrease in SFA was found with a significant decrease in the proportion of butyric acid.

Conclusion. The inclusion of Zakofalk® in the ET scheme, in comparison with probiotics, significantly increases the probability of successful eradication, more effectively restores the metabolic potential of the microbiota, and prevents the development of AAD.


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About the authors

L. I. Butorova

Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: ludmilabutorova@mail.ru
ORCID iD: 0000-0003-4689-2844

Russian Federation, Moscow

к.м.н., доц. каф. поликлинической терапии Института клинической медицины им. Н.В. Склифосовского

M. D. Ardatskaya

Central State Medical Academy of the President of the Russian Federation

Email: ludmilabutorova@mail.ru
ORCID iD: 0000-0001-8150-307X

Russian Federation, Moscow

д.м.н., проф. каф. гастроэнтерологии

M. A. Osadchuk

Sechenov First Moscow State Medical University (Sechenov University)

Email: ludmilabutorova@mail.ru
ORCID iD: 0000-0003-0485-6802

Russian Federation, Moscow

д.м.н., проф., зав. каф. поликлинической терапии Института клинической медицины им. Н.В. Склифосовского

N. G. Kadnikova

Central Clinical Hospital for Rehabilitation Treatment

Email: ludmilabutorova@mail.ru
ORCID iD: 0000-0002-8228-0522

Russian Federation, Moscow

зав. отд-нием, врач-гастроэнтеролог

E. I. Lukianova

City Polyclinic №201

Email: ludmilabutorova@mail.ru
ORCID iD: 0000-0002-4989-9964

Russian Federation, Zelenograd

врач-гастроэнтеролог высшей квалификационной категории, внештат. специалист, гастроэнтеролог Зеленоградского округа Москвы

R. G. Plavnik

ISOCARB LLC

Email: ludmilabutorova@mail.ru
ORCID iD: 0000-0001-5448-8812
SPIN-code: 9614-1127

Russian Federation, Moscow

к.м.н., зам. ген. дир. по науке и внедрению

E. V. Sayutina

Sechenov First Moscow State Medical University (Sechenov University)

Email: ludmilabutorova@mail.ru
ORCID iD: 0000-0001-9611-5096

Russian Federation, Moscow

к.м.н., ассистент каф. поликлинической терапии Института клинической медицины им. Н.В. Склифософского

T. B. Topchiy

Central State Medical Academy of the President of the Russian Federation

Email: ludmilabutorova@mail.ru
ORCID iD: 0000-0003-4491-881X

Russian Federation, Moscow

к.м.н., доц. каф. гастроэнтерологии

E. M. Tuayeva

Sechenov First Moscow State Medical University (Sechenov University)

Email: ludmilabutorova@mail.ru
ORCID iD: 0000-0002-6542-2277

Russian Federation, Moscow

к.м.н., ассистент каф. поликлинической терапии Института клинической медицины им. Н.В. Склифософского

References

  1. Malfertheiner P, Megraud F, O’Morain CA, et al. Management of Helicobacter pylori infection – the Maastricht V/Florence Consensus Report. Gut. 2017;66:6-30. doi: 10.1136/gutjnl-2016-312288. Epub 2016 Oct 5.
  2. Ивашкин В.Т., Маев И.В., Лапина Т.Л. и др. Клинические рекомендации Российской гастроэнтерологической ассоциации по диагностике и лечению инфекции Helicobacter pylori у взрослых. Рос. журн. гастроэнтерол. гепатол. колопроктол. 2018; 28(1):55-70 [Ivashkin VT, Mayev IV, Lapina TL, et al. Diagnostics and treatment of Helicobacter pylori infection in adults: Clinical guidelines of the Russian gastroenterological association. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2018;28(1):55-70 (In Russ.)]. doi: 10.22416/1382-4376-2018-28-1-55-70
  3. Hudson N, Brydon WG, Eastwood MA, et al. Successful Helicobacter pylori eradication incorporating a one-week antibiotic regimen. Aliment Pharmacol Ther. 1995 Feb;9(1):47-50. PMID: 7766743. doi: 10.1111/j.1365-2036.1995.tb00350.x
  4. Yuan Y, Ford AC, Khan KJ, et al. Optimum duration of regimens for Helicobacter pylori eradication. Cochrane Database of Systematic Reviews. 2013 Dec 11. Issue 12:CD008337. doi: 10.1002/14651858.CD008337.pub2
  5. Pleura DA, Crowe SE. Helicobacter pylori. In: L. Feldman, L. Friedman, J. Brandt, Eds., Sleisenger and Fordtran’s Gastrointestinal and Liver Disease, Saun ders Elsevier, Philadelphia, 2010; p. 833-43.
  6. Li L, Zhou X, Xiao S, et al The Effect of Helicobacter pylori Eradication on the Gastrointestinal Microbiota in Patients with Duodenal Ulcer. J Gastrointestin Liver Dis. 2016 Jun;25(2):139-46. doi: 10.15403/jgld.2014.1121.252.hpe
  7. Antharam VC, Li EC, Ishmael A, et al. Intestinal dysbiosis and depletion of butyrogenic bacteria in Clostridium difficile infection and nosocomial diarrhea. J Clin Microbiol. 2013 Sep;51(9):2884-92. doi: 10.1128/JCM.00845-13. Epub 2013 Jun 26.
  8. Shimbo I, Yamaguchi T, Odaka T, et al. Effect of Clostridium butyricum on fecal flora in Helicobacter pylori eradication therapy. World J Gastroenterol. 2005 Dec 21;11(47):7520-4. PMID: 16437727.
  9. Bafeta A, Koh M, Riveros C, et al. Harms Reporting in Randomized Controlled Trials of Interventions Aimed at Modifying Microbiota: A Systematic Review. Ann Intern Med. 2018 Aug 21;169(4):240-7. doi: 10.7326/M18-0343. Epub 2018 Jul 17.
  10. Malfertheiner P, Megraud F, O’Morain CA, et al. Management of Helicobacter pylori infection – the Maastricht IV/Florence Consensus Report. Gut. 2012 May;61(5):646-64. doi: 10.1136/gutjnl-2012-302084
  11. Ильчишина Т.А. Комплаенс при эрадикации Helicobacter pylori: современные подходы к повышению приверженности и результаты собственного исследования. Лечащий врач. 2019;5;71-5 [Ilchishina TA. Compliance with Helicobacter pylori eradication: modern approaches to increase in commitment and the results of own research. Attending Physician. 2019;5:71-5 (In Russ.)].
  12. Буторова Л.И., Плавник Т.А., Кадникова Н.Г. Значение дисбиотических нарушений толстой кишки в патогенезе Helicobacter pylori-ассоциированных заболеваний гастродуоденальной зоны. Роль пребиотиков в повышении эффективности антихеликобактерной терапии. Лечащий врач. 2013;3:92-6 [Butorova LI, Plavnik TA, Kadnikova NG. The significance of the dysbiotic disorders of the colon in the pathogenesis Helicobacter pylori associated diseases of the gastroduodenal zone. The role of prebiotics in improving the effectiveness of anti-helikobacter therapy. Attending Physician. 2013;3:92-6 (In Russ.)].
  13. Nista E. Effect of butyric acid and inulin supplementation on side effects of anti H. pylori therapy: preliminary data. J Digest Liver Dis. 2006;38(1). doi: 10.1016/S1590-8658(06)801
  14. Плавник Р.Г. 13С-уреазный дыхательный тест на Helicobacter pylori (клинические и организационные аспекты). М.: МЕДПРАКТИКА-М, 2017 [Plavnik RG. 13C-urease respiratory test for Helicobacter pylori (clinical and organizational aspects). Moscow: MEDPRAKTIKA-M, 2017 (In Russ.)].
  15. Новик А.А., Ионова Т.И. Руководство по исследованию качества жизни в медицине. Под ред. Ю.Л. Шевченко. М.: Из-во РАЕН, 2012 [Novik AA, Ionova TI. Guide to the Study of quality of life in medicine. Ed. by YL Shevchenko. Moscow: RAEN, 2012 (In Russ.)].
  16. Gracham DY, Lee YC, Wu MS. Rational Helicobacter pylori therapy; evidense-based midicine rather than medicine-based evidence. Clin Gastroenterol Hepatol. 2014:12:177-86.
  17. Ардатская М.Д. и др. Антибиотико-ассоциированные поражения кишечника в практике клинициста. Пособие для врачей. М.: Прима Принт, 2020 [Ardatskaya MD, et al. Antibiotic-associated bowel lesions in clinician practice: a manual for doctors. Moscow: Prima-Print, 2020 (In Russ.)].
  18. Ардатская М.Д. Масляная кислота и инулин в клинической практике: теоретические аспекты и возможности клинического применения (пособие для врачей). М.: Форте принт, 2014 [Ardatskaya MD. Butter acid and inulin in clinical practice: theoretical aspects and possibilities of clinical use (medical manual). Moscow: Forte Print, 2014 (In Russ.)].

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