Role of yeasts in the qualitative structuring of extra virgin olive oil

This review sought to describe the role played by some components of the microbiota of extra virgin olive oil (EVOO), particularly yeasts, in structuring the physicochemical and sensorial quality of freshly produced olive oil. Yeasts can survive during the entire storage period of the product. To date, approximately 25 yeast species isolated from oil produced in more than six countries have been identified, eight of which are classified as new species. Some yeast species improve the health qualities of oil, whereas many others improve the chemical composition and sensory characteristics based on β-glucosidase and esterase enzymes, which are involved in the hydrolysis of the bitter glucoside known as oleuropein. However, some species, which are typically favoured by the high water content in the oily matrix, such as lipase-producing yeasts, can worsen the initial chemical characteristics of EVOO oil during storage. Some physical treatments that are compatible with the EVOO production specification affect the biotic component of the oil by reducing the concentration of yeasts. The possibility of minimizing the invasive action on the biotic component of the oil by appropriately selecting the physical treatment for each oil is discussed.     

益生菌在幽门螺杆菌根除治疗中的应用

幽门螺杆菌(Helicobacter pylori,H.pylori)是导致活动性胃炎、消化性溃疡、胃癌、胃黏膜相关淋巴组织淋巴瘤等消化系统疾病的重要病因之一,已被世界卫生组织确认为Ⅰ类致癌因子,根除H.pylori对防治上述疾病有重要意义。目前临床上主要采用含抗生素的三联或四联药物进行H.pylori的根除,虽然取得一定的疗效,但随着抗生素耐药率逐年增加,根除率持续下降,限制了其广泛应用。此外,初次或多次治疗失败后再治疗可选择的药物很少。近年来人们开始尝试将益生菌应用在H.pylori根除治疗中,并取得一定疗效。本文就益生菌在辅助根除幽门螺杆菌方面的研究进展作一简单综述。     

Efficacy of cranberry juice on Helicobacter pylori infection: a double-blind, randomized placebo-controlled trial

BACKGROUND: Helicobacter pylori infection is a major cause of peptic ulcer disease and gastric cancer. This study postulated that cranberry juice would be effective in the suppression of H. pylori in an endemically infected population at high risk for gastric cancer. MATERIALS AND METHODS: A prospective, randomized, double-blind, placebo-controlled trial was conducted in Linqu County of Shandong Province, China, where 189 adults aged 48.9 +/- 11.2 years (mean +/- SD) with H. pylori infection were randomly divided into two groups: cranberry juice (n = 97) and placebo (n = 92). Participants were assigned to orally receive two 250-ml juice boxes of cranberry juice or matching placebo beverage daily for 90 days. The degree of H. pylori infection was determined using the 13C-urea breath test before randomization at 35 and 90 days of intervention to assess the efficacy of cranberry juice in alleviating infection. RESULTS: A total of 189 subjects with positive 13C-urea breath test results prior to randomization completed the study. At day 35 of intervention, 14 of the 97 (14.43%) from the the cranberry juice treatment group and 5 of the 92 (5.44%) of the placebo recipients had negative 13C-urea breath test results. After 90 days, the study concluded that 14 of the 97 subjects in the cranberry juice treatment group versus 5 of the 92 in the placebo group yielded negative test results. Eleven individuals from the cranberry juice treatment group and only two from the placebo group were negative at 35 and 90 days of experiment. These results are significant (p < .05). CONCLUSIONS: Regular consumption of cranberry juice can suppress H. pylori infection in endemically afflicted populations.     

The effects of probiotics on PPI-triple therapy for Helicobacter pylori eradication

Background: This study was performed to evaluate whether the addition of probiotics to proton pump inhibitor (PPI)‐based triple therapy increases the likelihood of successful Helicobacter pylori eradication. Materials and Methods: Three hundred and forty‐seven H. pylori‐infected patients were randomized into a triple‐plus‐yogurt group (yogurt group, n = 168) or a triple‐only group (control group, n = 179). Triple therapy consisted of PPI b.i.d., clarithromycin 500 mg b.i.d., and amoxicillin 1 g b.i.d. for 7 days. Yogurt group received triple therapy for 1 week and one bottle of Will yogurt per day for at 3 weeks, starting on the first day of triple therapy. Will yogurt (a Korean brand) contains Lactobacillus acidophilus HY2177, Lactobacillus casei HY2743, Bifidobacterium longum HY8001, and Streptococcus thermophilus B‐1. ¹³C‐urea breath test was performed at least 4 weeks after completion of triple therapy. Eradication rates, compliances, and adverse events were compared. Results: By intention‐to treat analysis the H. pylori eradication rates in the yogurt group 79.2% (133 of 168) was similar to that in the control group 72.1% (129 of 179) (p = .124). However, by per‐protocol (PP) analysis, the eradication rate in the yogurt group, 87.5% (133 of 152) was higher than that in the control group, 78.7% (129 of 164) (p = .037). Common adverse events were metallic taste (11.8%) and diarrhea (8.6%). The frequency of adverse effects in the yogurt group 41.1% (69/168) were higher than in the control group, 26.3% (47 of 179) (p = .003). However, most adverse events were mild to moderate in intensity, and the severities of adverse effects were similar in both groups (p = .401). Conclusions: The addition of Will yogurt to triple therapy did not reduce the side‐effects of triple therapy. But it increased the H. pylori eradication rate by PP analysis, encouraging more research in this field.     

Total family unit Helicobacter pylori eradication and pediatric re-infection rates

BACKGROUND: Re-infection with Helicobacter pylori is more common in children than adults, and it is generally accepted that the family unit plays a significant role in primary childhood infection. We investigated whether the family unit plays a significant role in pediatric re-infection and if eradication of H. pylori from the entire family reduces the risk of childhood re-infection. METHODS: Fifty families, each with an H. pylori-infected pediatric index case (mean age 9.48 years), were recruited. A 13carbon urea breath test was performed on all family members in the same house as the index case. Each family unit was randomized into a 'family unit treatment' group (all infected family members treated) or an 'index case treatment' group (index case only treated). RESULTS: At long-term follow-up (mean 62.2 months), there were three re-infected children in the 'index case treatment' group compared with one in the 'family unit treatment' group. The re-infection rate was 2.4% per patient per year in the 'index case treatment' group and 0.7% per patient per year in the 'family unit treatment' group (p = .31). CONCLUSIONS: This study is the first to evaluate the effect of total family unit H. pylori eradication on pediatric re-infection rates and reports the longest period of re-infection follow-up in children. In childhood, re-infection with H. pylori is not significantly reduced by family unit H. pylori eradication.     

乳杆菌治疗幽门螺杆菌感染疗效的Meta分析

目的 系统评价乳杆菌治疗幽门螺杆菌（H. pylori）感染的有效性。方法 计算机检索PubMed、Cochrane Central Register of Controlled Trials、Clinicatrials.gov、中国临床试验注册中心（http://www.chictr.org.cn/）、中国知网（CNKI）、万方数据库。检索时间从建库至2016年6月30日。此外追索已纳入文献和综述的参考文献。经两位研究者独立筛选文献、提取资料和评价质量,交叉核对后,采用Stata 12.0进行Meta分析。结果 最终纳入17个RCT,共1 758例患者。Meta分析结果：乳杆菌联合常规三联疗法能提高H. pylori根除率[OR=2.762,95%CI(2.163,3.526),P<0.001],降低不良反应发生率[OR=0.334,95%CI(0.242,0.461),P<0.001],但乳杆菌单独应用对H. pylori根除率结果与对照组比较差异无统计学意义。根据乳杆菌给药疗程的亚组分析结果,0~14（含14）d乳杆菌联合给药方案显著提高了H. pylori根除率[OR=2.893,95%CI(2.187,3.827),P<0.05],14~28（含28）d给药疗程也显著提高了H. pylori根除率[OR=2.619,95%CI(1.652,4.153),P<0.05]。乳杆菌联合三联疗法在欧洲人群及亚洲人群的亚组分析中,均提高了H. pylori根除率。结论 乳杆菌联合三联疗法有利于提高H. pylori根除率,并能降低总不良反应的发生,在H. pylori感染相关疾病的治疗中具有一定意义。     

影响幽门螺杆菌根除疗效相关因素

幽门螺杆菌（Hp）是慢性活动性胃炎和消化性溃疡的主要病因,并与胃癌、MALT淋巴瘤的发生密切相关,其根除治疗在临床上具有重要的意义。大量研究显示Hp的根除疗效在下降,本文就有关影响Hp根除疗效的相关因素做一简要概述。     

Phenylphosphonate transport by Helicobacter pylori

BACKGROUND: Helicobacter pylori can utilize phenylphosphonate as a sole source of phosphorus, and it is able to transport the phosphonate N-phosphonoacetyl-L-aspartate. However, H. pylori does not have any genes homologous to those of the known pathways for phosphonate degradation in bacteria, indicating that it must have novel pathways for the transport and metabolism of phosphonates. METHODS: Phenylphosphonate transport by H. pylori was studied in strains LC20, J99 and N6 by the centrifugation through oil method using [(14)C]-labeled phenylphosphonate. RESULTS: The Michaelis constants of transport K(t) and V(max) for phenylphosphonate showed similar kinetics in the three strains. The Arrhenius plot for phenylphosphonate transport rates at permeant concentrations of 50 micromol/L was linear over the temperature range 10-40 degrees C with an activation energy of 3.5 kJ/mol, and a breakpoint between 5 and 10 degrees C. Transport rates increased with monovalent cation size. The effects of various inhibitors were investigated: iodoacetamide, amiloride, valinomycin, and nigericin reduced the rate of phenylphosphonate transport; sodium azide and sodium cyanide increased the transport rate; and monensin had no effect. CONCLUSIONS: The kinetics and properties of H. pylori phenylphosphonate transport were characterized, and the data suggested a carrier-mediated transport mechanism.     

A new modified concomitant therapy for Helicobacter pylori eradication in Turkey

Background: Helicobacter pylori eradication rates have tended to decrease recently, mostly due to antibiotic resistance. In the present study, our aim was to determine Hp eradication rate with the LAC plus tid metronidazole regimen and the secondary objective of this study was to identify an effective regimen for our population. Methods: Eighty‐four Hp‐positive patients with non‐ulcer dyspepsia were assigned into the same group. Patients were administered the classical LAC protocole (lansoprazole 30 mg bid, amoxicillin 1 g bid and claritromycin 500 mg bid for 14 days) plus metronidazole 500 mg tid for 14 days. Gastroscopy and histopathological assessment were performed before enrollment and C¹⁴ urea breath test and stool antigen test were performed 6 weeks after treatment. Results: All 84 patients completed the study. No patient left the study because of drug side effect. Total eradication rate was 75% (63/84). Conclusion: Although LAC plus tid metronidazole regimen achieved a much better eradication rate compared with the standard LAC regimen; this is the first study that has a relatively low success with a concomitant therapy. So in areas of high resistance like Turkey, one cannot expect a high success with any clarithromycin containing regimen and those should be avoided.     

幽门螺杆菌根除疗法对肠道微生态的影响

幽门螺杆菌(Helicobacter pylori)感染是世界范围关注的焦点,进行幽门螺杆菌根除治疗是世界各国针对感染所采取的一项重要举措。但随着幽门螺杆菌耐药率,尤其是对大环内酯类药物耐药率的增加,标准三联疗法根除效果逐渐不能满足需求,更多的疗法得以推出。但是新推出的诸多疗法都应用了比以前更大剂量、更多种类甚至更长疗程的抗生素,这对于肠道微生物的微生态结构和数量都可能造成严重影响,甚至可能产生严重的副作用,同时也可能会对其耐药性产生影响。本文回顾了近20年来幽门螺杆菌根除治疗对肠道微生态的影响和一些新型实验疗法的研究结果,以对上述问题进行探讨。     

Immunity markers in patients with Helicobacter pylori infection: effect of eradication

BACKGROUND: Helicobacter pylori is a microorganism able to stimulate a robust inflammatory and systemic immune response. AIM: The aim of our study was to evaluate autoimmune markers in dyspeptic patients positive for H. pylori infection compared to a control group of non-H. pylori-infected subjects. The kinetics of cryoglobulins and autoantibodies was evaluated after treatment of the infection. PATIENTS AND METHODS: Dyspeptic patients with active H. pylori infection and age- and sex-matched healthy H. pylori-negative controls were studied. Markers of immunity were compared, in H. pylori-infected patients before, 6 months and 1 year after the end of therapy. Results were also compared between those with and without successful eradication therapy. RESULTS: Eighty-six individual were entered (43 H. pylori-infected). H. pylori-infected patients had higher levels of IgG and/or IgA and/or IgM (22/43 versus 2/43). Circulating immune complexes and cryoglobulins were detected in patients more often than controls (p < .05 for both). Autoantibodies were observed in 13 patients (30% versus 5% in controls) and antithyroid antibodies in 12 (p < .04 versus controls). Lower levels of C3 and/or C4 complement fractions were observed in infected patients with respect to controls (7/43 versus 1/43; p = .014). After 1 year of follow-up, the markers of autoimmunity dramatically improved in patients eradicated for H. pylori infection compared to those in whom therapy failed. No patient developed a clinical autoimmune disorder. CONCLUSIONS: Additional studies are necessary to ascertain the clinical significance of the modifications of autoimmune markers in patients with H. pylori infection.     

Persisting chronic gastritis and elevated Helicobacter pylori antibodies after successful eradication therapy

AIM: The persistence of chronic inflammation in gastric mucosa and elevated Helicobacter pylori antibodies after successful eradication therapy are common findings in clinical practice. We studied their possible association with each other and disappearance in long-term follow up, as well as their possible connection with gastric atrophy. PATIENTS AND METHODS: The study population consisted of 108 dyspeptic patients with successful eradication therapy median 6.4 years earlier. The patients underwent gastroscopy, and biopsies from antrum and corpus were evaluated by an experienced pathologist. Serum samples collected from 77 patients were studied for H. pylori antibodies, parietal cell antibodies, as well as for pepsinogen I, pepsinogen II, and gastrin-17 levels. RESULTS: The prevalence of chronic gastric inflammation and elevated H. pylori antibodies after successful eradication therapy decreased by time, but still after 5 years, 17 of 51 (33%) subjects had elevated H. pylori antibodies and 14 of 68 (21%) had a mild inactive chronic inflammation in gastric mucosa. In patients with and without chronic inflammation in gastric mucosa, elevated H. pylori antibodies were detected in three of 10 (30%) and 14 of 41 (34%), elevated parietal cell antibodies in one of 10 (10%) and six of 41 (15%), low pepsinogen I in one of 10 (10%) and none of 41, and elevated gastrin-17 in three of 10 (30%) and six of 41 (15%), respectively. CONCLUSION: More than 5 years after successful H. pylori eradication therapy, mild persistent chronic inflammation may occur in gastric mucosa in up to one-fifth and elevated H. pylori antibodies even in one-third of patients, although these two are independent phenomena.     

The effects of nocturnal acid breakthrough on Helicobacter pylori eradication

Background. The effects of nocturnal gastric acid breakthrough (NAB) on Helicobacter pylori eradication are still unknown in peptic ulcer patients. The purposes of this study were to compare the effect of lansoprazole 30 mg twice a day (bid) to lansoprazole 60 mg once a day (qd) on the prevalence of NAB, and to determine whether NAB affects the eradication of H. pylori in peptic ulcer patients. Methods. Experiments were carried out in 67 patients with H. pylori‐positive peptic ulcers. They were randomized into two groups, one treated with a combination of lansoprazole 60 mg, clarithromycin 1.0 g, and amoxycillin 2.0 g once a day before breakfast (qd group), and the other, divided doses of the drugs were given before breakfast and dinner (bid group) for 2 weeks. Results. NAB occurred in 31 patients, 55.2% in qd group, and 39.5% in bid group (p = .226). H. pylori eradication was achieved in 61.3% in NAB positive group and 83.3% in NAB negative group (p = .055). The mean duration of NAB for H. pylori eradication group was 99.3 ± 22.7 min, and 293.2 ± 49.8 min for H. pylori persistence group (p < .05). The median intragastric pH of the H. pylori eradication and persistence group was 5.7 ± 0.2 and 4.2 ± 0.4, respectively (p < .05). Conclusions. Neither the morning dose and the divided dose regimen of lansoprazole affected the intragastric acidity and occurrence of the NAB. NAB did not influence H. pylori eradication in peptic ulcer patients, but the duration of NAB and total intragastric median pH were found to influence the H. pylori eradication.     

Clinical Significance of IgG Antibody Titer against Helicobacter pylori

Background: We clarified the clinical significance of measurement of IgG antibody titers against Helicobacter pylori using data from a nested case–control study from a large-scale cohort study in Japan.
Method: Participants included 36,745 subjects from the Japan Health Center-based Prospective Study who responded to the baseline questionnaire and provided a blood sample. Subjects were aged 40–69 years and were followed over 15 years after initial sampling. Controls were matched to 511 gastric cancer patients. Plasma surface antigen (Hp)-IgG titer was measured using ELISA, and mucosal atrophy was determined by measuring pepsinogen I and II levels.
Results: Seropositive subjects with low Hp-IgG titer and mucosal atrophy showed a higher risk for gastric cancer than high-titer subjects. Odds ratio (OR) referred to cases with true negative IgG titers and no mucosal atrophy. In moderately atrophic subjects, the low titer OR was 19.0, with a 95% confidence interval (CI) of 7.7–46.9, and 12.5 for high titer, with a 95% CI of 5.2–30.0. In severely atrophic subjects, the low titer OR was almost double that of high-titer subjects (OR = 30.2, 95% CI = 12.4–73.7 and OR = 15.9, 95% CI = 6.3–40.3, respectively). These associations were observed more frequently for differentiated than undifferentiated gastric cancer.
Conclusion: Combination assay with Hp-IgG titer and pepsinogens may help identify groups at high risk for gastric cancer. Subjects with low Hp-IgG titer and mucosal atrophy were at extremely high risk for gastric cancer, particularly differentiated cancer. Subjects with this background may require ongoing observation and periodic endoscopic examination for early cancer detection.     

益生菌对幽门螺杆菌根除后肠道微生物群分布的影响

目的 检验益生菌对幽门螺杆菌根除后肠道微生物群分布的影响。方法 病人分为三联疗法根除组（A组）和三联疗法根除+双歧杆菌三联活菌胶囊联用组（B组）。治疗14天后对病人治疗效果进行多方面评估。收集治疗后患者的粪便样本进行qPCR分析,检测大肠埃希菌、肠球菌、肺炎克雷伯菌、乳杆菌、双歧杆菌及嗜热链球菌的数量。结果 120例患者中有112例按方案完成治疗,完成率为93.3%。A组患者中失访2例,不耐受5例,治疗完成率为88.3%;B组患者中失访3例,不耐受4例,治疗完成率为88.3%。双歧杆菌三联活菌胶囊降低了患者的不良反应并提高了三联疗法根除的治愈率。A组大肠杆菌及肺炎克雷伯菌相对表达水平明显高于B组;然而B组粪肠球菌、双歧杆菌、乳酸杆菌及嗜热链球菌表达高于A组。结论 益生菌的使用对提高三联疗法根除幽门螺杆菌有促进作用。     

国内益生菌制剂清除幽门螺杆菌感染临床疗效的Meta分析

目的对益生菌制剂清除幽门螺杆菌（H.pylori）感染的临床疗效及其对治疗中抗生素相关的不良反应的改善情况进行系统评价。方法通过计算机检索CBMdisc、CNKI、VIP以及MEDLINE等数据库,全面收集中国地区应用益生菌制剂治疗且pylori感染的随机或半随机对照试验,并按Cochrane协作网推荐的方法对其进行Meta分析。并评价Meta分析结果的稳定性和发表偏倚。结果纳入15个试验包括1572例病人,对尼py／or／清除率和不良反应改善情况分别进行Meta分析显示,试验组Hpylori清除率（88．53％）明显高于对照组（82．73％）（合并OR为1．56,95％CI为1．17—2．08,总体效应检验,Z=2．99,P=0．003）;不良反应发生率分别为5．O％和24．3％,合并OR为0．16,95％cI为0．09—0．31,表明能显著改善治疗中的不良反应发生情况,且差异具有显著性。结论联合应用益生菌制剂可以提高抗皿pylori感染治疗中的清除率,单独应用益生菌制剂清除且pylori感染也有一定的疗效。同时,益生菌制剂对且pylori感染治疗中的不良反应有较显著的改善。益生菌制剂有可能对Hpylori感染及相关疾病的防治具有重要意义。     

Efficacy and safety of faropenem in eradication therapy of Helicobacter pylori

Aims: While triple therapy with a proton pump inhibitor, amoxicillin, and clarithromycin is the standard therapy for Helicobacter pylori eradication, it is ineffective against clarithromycin‐resistant strains. To seek a better regimen for eradication therapy, we assessed the sensitivity of clinical strains seen in Japan to faropenem and then evaluated the efficacy and safety of eradication therapy containing this antibiotic. Methods: Minimum inhibitory concentrations (MICs) of faropenem were determined in 78 Japanese clinical H. pylori isolates using the agar dilution method. H. pylori‐positive patients were consecutively assigned to a 7‐day eradication therapy protocol with LAF (lansoprazole 60 mg/day, amoxicillin 2000 mg/day, and faropenem 600 mg/day), and then to a 14‐day protocol. The outcomes of the therapies were assessed by ¹³C‐urea breath tests. Results: All 78 strains showed MICs of faropenem that were equal to or less than 0.2 µg/mL. The eradication rates according to intention‐to‐treat analyses were 46.5% with the 7‐day therapy (n = 43) and 62.5% with the 14‐day therapy (n = 32). No special measures were required to treat the adverse events observed in approximately one‐third of the patients. Conclusions: Faropenem was found to have good antimicrobial action against H. pylori in vitro. The 14‐day LAF therapy successfully eradicated H. pylori in about two‐thirds of the patients although the incidence of adverse events was high.     

Reversal of migraine symptoms by Helicobacter pylori eradication therapy in patients with hepatitis-B-related liver cirrhosis

Helicobacter pylori infection might be associated with vascular diseases, such as primary Raynaud phenomenon and coronary heart diseases. The possible mechanism might be due to H. pylori antigens causing intermittent vasospasm of arterioles, which also played roles in the development of liver cirrhosis. Migraine, a functional vascular disease, was observed in many patients with cirrhosis in the clinic. This study aimed to assess the effects of H. pylori eradication on migraine symptoms in patients with hepatitis-B-virus-related cirrhosis. The results clearly showed that the intensity, duration, and frequency of attacks of migraine were significantly reduced in all the patients in whom H. pylori has been eradicated. Thus, the study pushed further insight into the mechanisms of migraine pathogenesis.     

益生菌联合四联疗法对幽门螺杆菌感染补救治疗的疗效分析

目的 评价联合应用益生菌在标准四联疗法的不同阶段对幽门螺杆菌（H. pylori）感染补救治疗的疗效。方法 采用回顾性研究,收集首次根除失败因病情需要接受H.pylori补救根除治疗的患者共200例,随机分为4个治疗组,所有患者均采用标准四联疗法（每次服用埃索美拉唑钠肠溶片20 mg＋枸橼酸铋钾220 mg＋阿莫西林1 000 mg+呋喃唑酮100 mg）进行治疗。其中A组为单纯四联治疗,不加服金双歧;B组为四联治疗前2周服用金双歧2 000 mg/次;C组为标准四联治疗同时服用金双歧2 000 mg/次;D组为四联治疗结束后开始加用金双歧2 000 mg/次。疗程均为2周,所有患者均随访至少4周,记录其治疗期间发生的不良反应及症状。疗程结束4周后采用13C尿素呼气试验判断H. pylori是否根除。结果 A组、B组、C组和D组患者ITT分析的根除率分别为78.0%（38/50）、80.0%（40/50）、74.0%（37/50）和72.0%（36/50）,差异无统计学意义（χ2=1.096,P=0.778）;4组患者PP分析的根除率分别为81.3%（39/48）、85.1%（40/47）、78.7%（37/47）和78.3%（36/46）,差异无统计学意义（χ2=0.891,P=0.828）。4组患者7 d、14 d不良反应发生率差异有统计学意义（P0.05）。结论 含呋喃唑酮、阿莫西林的标准四联疗法治疗H. pylori感染根除率较高（>80％）,可作为首次根除治疗失败后的补救治疗方案,在补救治疗的不同时期加用益生菌并不能明显提高根除率,但能降低7 d、14 d治疗期间的不良反应发生率。