DOI QR코드

DOI QR Code

The Efficacy of Saccharomyces boulardii CNCM I-745 in Addition to Standard Helicobacter pylori Eradication Treatment in Children

  • Zhang, Bin (Department of Digestion, Shanghai Children's Medical Center, Medical College of Shanghai Jiao Tong University) ;
  • Xu, Ya-Zheng (Department of Digestion, Shanghai Children's Medical Center, Medical College of Shanghai Jiao Tong University) ;
  • Deng, Zhao-Hui (Department of Digestion, Shanghai Children's Medical Center, Medical College of Shanghai Jiao Tong University) ;
  • Chu, Bo (Department of Digestion, Shanghai Children's Medical Center, Medical College of Shanghai Jiao Tong University) ;
  • Jiang, Li-Rong (Department of Digestion, Shanghai Children's Medical Center, Medical College of Shanghai Jiao Tong University) ;
  • Vandenplas, Yvan (Department of Pediatrics, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel)
  • Received : 2014.12.01
  • Accepted : 2015.01.12
  • Published : 2015.03.30

Abstract

Purpose: This study aims to investigate Saccharomyces boulardii CNCM I-745 during Helicobacter pylori eradication in children. Methods: One hundred ninety-four H. pylori positive children were randomized in two groups. Therapy (omeprazole+ clarithromycin+amoxicillin or omeprazole+clarithromycin+metronidazole in case of penicillin allergy) was given to both groups during two weeks. In the treatment group (n: 102) S. boulardii was added to the triple therapy, while the control group (n: 92) only received triple therapy. The incidence, onset, duration and severity of diarrhea and compliance to the eradication treatment were compared. A $^{13}C$ urea breath test was done 4 weeks after the end of eradication therapy in two groups of 21 patients aged 12 years and older to test the H. pylori eradication rate. Results: In the treatment group, diarrhea occurred in 12 cases (11.76%), starting after $6.25{\pm}1.24days$, lasting $3.17{\pm}1.08days$, and compliance to eradication treatment was 100%. In the control group, diarrhea occurred in 26 cases (28.26%), starting after $4.05{\pm}1.11days$, lasting $4.02{\pm}0.87days$, and in six cases eradication treatment was stopped prematurely (p<0.05). The $^{13}C$ urea breath test showed successful H. pylori eradication in 71.4% of the patients in the treatment and in 61.9 % in the control group (not significant). Conclusion: S. boulardii has a beneficial effect on the prevention and treatment of diarrhea during H. pylori eradication in children. Although S. boulardii did only slightly increase H. pylori eradication rate, compliance to eradication treatment was improved.

Keywords

References

  1. Jafri W, Yakoob J, Abid S, Siddiqui S, Awan S, Nizami SQ. Helicobacter pylori infection in children: population-based age-specific prevalence and risk factors in a developing country. Acta Paediatr 2010;99:279-82.
  2. Yang XQ, Yi ZW. Pediatrics. 6th ed. Beijing: People's Medical Publishing House, 2003:295-6.
  3. Ng SC, Hart AL, Kamm MA, Stagg AJ, Knight SC. Mechanisms of action of probiotics: recent advances. Inflamm Bowel Dis 2009;15:300-10. https://doi.org/10.1002/ibd.20602
  4. Preidis GA, Versalovic J. Targeting the human microbiome with antibiotics, probiotics, and prebiotics: gastroenterology enters the metagenomics era. Gastroenterology 2009;136:2015-31. https://doi.org/10.1053/j.gastro.2009.01.072
  5. Koletzko S, Jones NL, Goodman KJ, Gold B, Rowland M, Cadranel S, et al; H pylori Working Groups of ESPGHAN and NASPGHAN. Evidence-based guidelines from ESPGHAN and NASPGHAN for Helicobacter pylori infection in children. J Pediatr Gastroenterol Nutr 2011;53:230-43.
  6. Wallace JL, Syer S, Denou E, de Palma G, Vong L, McKnight W, et al. Proton pump inhibitors exacerbate NSAID-induced small intestinal injury by inducing dysbiosis. Gastroenterology 2011;141:1314-22. https://doi.org/10.1053/j.gastro.2011.06.075
  7. Higuchi K, Maekawa T, Nakagawa K, Chouno S, Hayakumo T, Tomono N, et al. Efficacy and safety of Helicobacter pylori eradication therapy with omeprazole, amoxicillin and high-and low-dose clarithromycin in Japanese patients: a randomised, double-blind, multicentre study. Clin Drug Investig 2006;26:403-14. https://doi.org/10.2165/00044011-200626070-00002
  8. Hurduc V, Plesca D, Dragomir D, Sajin M, Vandenplas Y. A randomized, open trial evaluating the effect of Saccharomyces boulardii on the eradication rate of Helicobacter pylori infection in children. Acta Paediatr 2009;98:127-31. https://doi.org/10.1111/j.1651-2227.2008.00977.x
  9. Szajewska H, Horvath A, Piwowarczyk A. Meta-analysis: the effects of Saccharomyces boulardii supplementation on Helicobacter pylori eradication rates and side effects during treatment. Aliment Pharmacol Ther 2010;32:1069-79. https://doi.org/10.1111/j.1365-2036.2010.04457.x
  10. Swidsinski A, Loening-Baucke V, Verstraelen H, Osowska S, Doerffel Y. Biostructure of fecal microbiota in healthy subjects and patients with chronic idiopathic diarrhea. Gastroenterology 2008;135:568-79. https://doi.org/10.1053/j.gastro.2008.04.017
  11. Barc MC, Charrin-Sarnel C, Rochet V, Bourlioux F, Sandre C, Boureau H, et al. Molecular analysis of the digestive microbiota in a gnotobiotic mouse model during antibiotic treatment: influence of Saccharomyces boulardii. Anaerobe 2008;14:229-33. https://doi.org/10.1016/j.anaerobe.2008.04.003
  12. McFarland LV. Systematic review and meta-analysis of Saccharomyces boulardii in adult patients. World J Gastroenterol 2010;16:2202-22. https://doi.org/10.3748/wjg.v16.i18.2202
  13. Vandenplas Y, Brunser O, Szajewska H. Saccharomyces boulardii in childhood. Eur J Pediatr 2009;168: 53-65.
  14. Cadamuro AC, Rossi AF, Maniezzo NM, Silva AE. Helicobacter pylori infection: host immune response, implications on gene expression and microRNAs. World J Gastroenterol 2014;20:1424-37. https://doi.org/10.3748/wjg.v20.i6.1424
  15. Beswick EJ, Suarez G, Reyes VE. H. pylori and host interactions that influence pathogenesis. World J Gastroenterol 2006;12:5599-605. https://doi.org/10.3748/wjg.v12.i35.5599
  16. Abdel-Latif MM, Windle H, Terres A, Eidhin DN, Kelleher D, Reynolds JV. Helicobacter pylori extract induces nuclear factor-kappa B, activator protein-1, and cyclooxygenase-2 in esophageal epithelial cells. J Gastrointest Surg 2006;10:551-62. https://doi.org/10.1016/j.gassur.2005.09.003
  17. Lopes AI, Quiding-Jarbrink M, Palha A, Ruivo J, Monteiro L, Oleastro M, et al. Cytokine expression in pediatric Helicobacter pylori infection. Clin Diagn Lab Immunol 2005;12:994-1002.
  18. Chen X, Kokkotou EG, Mustafa N, Bhaskar KR, Sougioultzis S, O'Brien M, et al. Saccharomyces boulardii inhibits ERK1/2 mitogen-activated protein kinase activation both in vitro and in vivo and protects against Clostridium difficile toxin A-induced enteritis. J Biol Chem 2006;281:24449-54. https://doi.org/10.1074/jbc.M605200200
  19. Dalmasso G, Cottrez F, Imbert V, Lagadec P, Peyron JF, Rampal P, et al. Saccharomyces boulardii inhibits inflammatory bowel disease by trapping T cells in mesenteric lymph nodes. Gastroenterology 2006;131:812-25.
  20. Thomas S, Przesdzing I, Metzke D, Schmitz J, Radbruch A, Baumgart DC. Saccharomyces boulardii inhibits lipopolysaccharide-induced activation of human dendritic cells and T cell proliferation. Clin Exp Immunol 2009;156:78-87. https://doi.org/10.1111/j.1365-2249.2009.03878.x
  21. Fidan I, Kalkanci A, Yesilyurt E, Yalcin B, Erdal B, Kustimur S, et al. Effects of Saccharomyces boulardii on cytokine secretion from intraepithelial lymphocytes infected by Escherichia coli and Candida albicans. Mycoses 2009;52:29-34.
  22. Gotteland M, Poliak L, Cruchet S, Brunser O. Effect of regular ingestion of Saccharomyces boulardii plus inulin or Lactobacillus acidophilus LB in children colonized by Helicobacter pylori. Acta Paediatr 2005;94: 747-51. https://doi.org/10.1080/08035250510028894
  23. Dupont C, Vernisse B. Anti-diarrheal effects of diosmectite in the treatment of acute diarrhea in children: a review. Paediatr Drugs 2009;11:89-99. https://doi.org/10.2165/00148581-200911020-00001
  24. Guarino A, Ashkenazi S, Gendrel D, Lo Vecchio A, Shamir R, Szajewska H. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases evidencebased guidelines for the management of acute gastroenteritis in children in Europe: update 2014. J Pediatr Gastroenterol Nutr 2014;59:32-52. https://doi.org/10.1097/MPG.0b013e3182952e74

Cited by

  1. Use of probiotics in pediatric infectious diseases vol.13, pp.12, 2015, https://doi.org/10.1586/14787210.2015.1096775
  2. Saccharomyces Boulardii in Helicobacter Pylori Eradication in Children: A Randomized Trial From Iran vol.26, pp.1, 2015, https://doi.org/10.5812/ijp.3768
  3. Probiotics improve the efficacy of standard triple therapy in the eradication of Helicobacter pylori : a meta-analysis vol.9, pp.None, 2015, https://doi.org/10.2147/idr.s117886
  4. Analysis of the effects of microbiome-related confounding factors on the reproducibility of the volatolomic test vol.10, pp.3, 2016, https://doi.org/10.1088/1752-7155/10/3/037101
  5. Effect of topically applied Saccharomyces boulardii on the healing of acute porcine wounds: a preliminary study vol.9, pp.None, 2015, https://doi.org/10.1186/s13104-016-2012-8
  6. Probiotics as Dietary Supplements for Eradication of Helicobacter pylori Infection in Children: A Role Beyond Infection vol.3, pp.4, 2016, https://doi.org/10.3390/children3040027
  7. Lactobacillus reuteri DSM 17938 in the prevention of antibiotic-associated diarrhoea in children: protocol of a randomised controlled trial vol.7, pp.1, 2015, https://doi.org/10.1136/bmjopen-2016-013928
  8. Cellular and molecular effects of yeast probiotics on cancer vol.43, pp.1, 2015, https://doi.org/10.1080/1040841x.2016.1179622
  9. Probiotics in 14-day triple therapy for Asian pediatric patients with Helicobacter pylori infection: a network meta-analysis vol.8, pp.56, 2015, https://doi.org/10.18632/oncotarget.21633
  10. Beneficial effects of Saccharomyces boulardii CNCM I-745 on clinical disorders associated with intestinal barrier disruption vol.12, pp.None, 2015, https://doi.org/10.2147/ceg.s181590
  11. Saccharomyces boulardii CNCM I-745 plus sequential therapy for Helicobacter pylori infections: a randomized, open-label trial vol.75, pp.5, 2015, https://doi.org/10.1007/s00228-019-02625-0
  12. Saccharomyces boulardii as an adjuvant therapy for Helicobacter pylori eradication: A systematic review and meta‐analysis with trial sequential analysis vol.24, pp.5, 2015, https://doi.org/10.1111/hel.12651
  13. Probiotics for the prevention of antibiotic-associated adverse events in children—A scoping review to inform development of a core outcome set vol.15, pp.5, 2015, https://doi.org/10.1371/journal.pone.0228824
  14. Treatment of Helicobacter pylori infection in children: A systematic review vol.8, pp.4, 2015, https://doi.org/10.13105/wjma.v8.i4.292
  15. Klinische Evidenz zu Probiotika in der Prävention einer Antibiotika-assoziierten Diarrhö : Systematischer Review vol.163, pp.suppl4, 2015, https://doi.org/10.1007/s15006-021-9762-5
  16. Perspectives from the Society for Pediatric Research: Probiotic use in urinary tract infections, atopic dermatitis, and antibiotic-associated diarrhea: an overview vol.90, pp.2, 2015, https://doi.org/10.1038/s41390-020-01298-1