2023Pylopass与幽门螺杆菌白皮书

1联合发罗伊氏乳杆菌 DSM 17648产品介绍白皮书诺维信OneHealth 热心肠研究院联 合 发 布与幽门螺杆菌白皮书3Kimmo Makinen- 诺维信 OneHealth 全球创新研发创始人陈烨 南方医科大学深圳医院副院长海南大学食品科学与工程学院教授张家超专家序言Helicobacter pylori is the most common infection in the world infecting around 50% of the world’s population. It causes peptic ulcers and gastric cancer as well as every-day digestive discomfort. Many cases of H. pylori are asymptomatic, but all individuals with H. pylori infection have degrees of gastritis, which over time can progress to severe symptoms. The current treatment guideline is to eradicate H. pylori using a combination of two antibiotics and a proton pump inhibitor known as triple-therapy. In some cases, a fourth drug, the anti-parasitic compound bismuth, is used, in which case we talk about quadruple therapy. The success of medical eradication ranges from 70% to 95%. The rates, however, have been declining due to increases in antibiotic resistance. Medical H. pylori therapies cause severe side effects which reduces treatment compliance. They also drive antibiotic resistance and cannot taken over long term. Hence, there is a need for effective natural solutions to control H. pylori. We wanted to find such a natural solution and screened 700 lactobacillus strains for their ability to bind to and co-aggregate with H. pylori. The hypothesis was that coaggregation would cause H. pylori to lose its grip on gastric mucosa and result in being flushed out of the digestive tract. We found one such L. reuteri strain, L. reuteri Pylopass, which we showed to avidly co-aggregate with several different pathogenic strains of H. pylori without binding to other pathogens or commercial gut-resident microbes. It did so as a live or as dead version, the latter of which became known as Pylopass. Over the past 15 years, we have conducted several clinical studies in asymptomatic and symptomatic H. pylori infected adults and children and have shown that Pylopass reduces H. pylori load in the stomach when taken as a stand-alone monotherapy for 2- 4 weeks. It has also been shown to increase H. pylori eradication success rates as an adjuvant to triple therapy, and to reduce triple therapy-associated side effects. We believe that Pylopass can be a powerful natural tool for fighting H. pylori infection globally without contributing to increase in antibiotic resistance. 幽门螺杆菌 (Helicobacter pylori, Hp) 是一种定植于人体胃内的革兰氏阴性专性厌氧菌，是慢性胃炎、消化性溃疡等胃病的主要致病因子，也是胃癌发生最明确、最可控的危险因素。1994 年，Hp 被世界卫生组织定义为 I 类致癌原；此后国际及国内多个指南及专家共识意见均强调根除Hp 可有效预防胃癌的发生。作为一种重要的人体致病菌，全球范围内约有一半人口感染 Hp；我国是 Hp 高感染国家，感染人数超过 7 亿，Hp 相关胃病的社会及经济负担巨大。目前，根除 Hp 的方案从三联变为四联，疗程不断延长，抗生素的种类和剂量不断调整，疗效提高有限，但副作用却逐渐增加，越来越多的患者反复治疗失败。幽门螺杆菌根除失败的原因包括治疗不规范、患者依从性差、Hp 对抗生素耐药等，其中耐药是 Hp 根除率下降的最主要原因，已成为治疗的最大挑战之一。探索治疗 Hp 感染的新路径已成为当前的研究热点。近年来，使用益生菌已经成为支持肠道健康和免疫的重要手段之一，大量体外研究、动物实验和临床观察均显示益生菌在辅助抗 Hp 方面具有降低不良反应、提高根除率的优势，是常规疗法的有益补充；然而，目前用于辅助抗 Hp 的益生菌种类众多、组合多样、使用剂量和时机不一，临床研究质量参差不齐，使得研究结果很难统一。本白皮书重点围绕 Hp 感染的危害、现状、防控和治疗等话题，对相关研究进展和国内外主要共识指南要点进行梳理，特别总结了益生菌中的重要成员罗伊氏乳杆菌用于 Hp 治疗的现有科学证据，从循证的角度对其临床研究和应用进行了探讨