Helicobacter pylori

H. pylori Infection & Gastric Ulcers

Discovery of H. pylori & Nobel Prize 2005

  • The Nobel Prize in Physiology or Medicine 2005 was awarded jointly to Barry J. Marshall and J. Robin Warren "for their discovery of the bacterium Helicobacter pylori and its role in gastritis and peptic ulcer disease“
  • In 1982, when this bacterium was discovered by Marshall and Warren, stress and lifestyle were considered the major causes of peptic ulcer disease. It is now firmly established that Helicobacter pylori causes more than 90% of duodenal ulcers and up to 80% of gastric ulcers

Overview

  • Helicobacter pylori (H. pylori) is a bacterium that is commonly found in the stomach
  • It is present in approximately 50% of the world's population
  • H. pylori infection is more common in adulthood in developed countries, however, most children in developing countries are infected with H. pylori before age 10
  • H. pylori is capable of causing a number of digestive problems, including ulcers and stomach cancer
  • H. pylori is probably spread by consuming food or water contaminated with fecal matter
  • H. pylori causes changes to the stomach and duodenum (first part of small intestine) leading to chronic inflammation in the walls of the stomach (gastritis) or duodenum (duodenitis)
  • As a result of these changes, the stomach and duodenum are more vulnerable to damage from digestive juices (stomach acid)

Symptoms

  • Some people with chronic gastritis or duodenitis develop more serious problems, including stomach or duodenal ulcers
  • Ulcers can cause a variety of symptoms:
  1. Abdominal pain or discomfort
  2. Bloating
  3. Lack of appetite
  4. Nausea or vomiting
  5. Dark-colored stools
  6. Bleeding ulcers can cause a low blood count and fatigue
  • Less commonly, chronic gastritis causes abnormal changes in the stomach lining, which can lead to certain forms of cancer
  • Since so many people in the world are infected with H. pylori, it is considered to be an important cause of stomach cancer
  • People living in developing countries in which H. pylori infection occurs at an early age are at greatest risk of stomach cancer

Treatment for H. pylori

  • No single drug cures H. pylori infection
  • Most treatment regimens involve taking several medications (triple therapy) for 14 days
  • At least two antibiotics that help to kill the bacteria are generally recommended in order to reduce the risk of treatment failure and antibiotic resistance
  • The other medication, a proton pump inhibitor (PPI), decreases the production of stomach acid thus helping the ulcer heal
  • A standard triple therapy is amoxicillin, clarithromycin, and a PPI

Example:

Triple therapy — The regimen most commonly recommended for first line treatment of H. pylori is triple therapy with a PPI (lansoprazole 30 mg twice daily, omeprazole 20 mg twice daily, pantoprazole 40 mg twice daily, rabeprazole 20 mg twice daily, or esomeprazole 20 mg twice daily or esomeprazole 40 mg once daily), amoxicillin (1 g twice daily), and clarithromycin (500 mg twice daily) for 14 days

Problems with Current Treatment

  • There are increasing numbers of patients with H. pylori infection that is resistant to antibiotics
  • In the United States, up to 50% of strains are resistant to metronidazole and 13% are resistant to clarithromycin
  • The treatment regimen that is selected must be effective, but considerations such as cost, side effects, and ease of administration should also be taken into account
  • Up to 50% of patients have side effects while taking H. pylori treatment

Despite the number of randomized controlled trials, the optimal therapeutic regimen has not yet been defined

H. Pylori & Gastric Cancer

  • 1 million cases of gastric cancer are diagnosed each year
  • Fourth most common cancer worldwide
  • Second leading cause of cancer related deaths each year (~700,000 people)
  • Infection with H. pylori bacteria seems to be a major cause of stomach cancer
  • 10% of infected individuals develop ulcers, 1-3% develop gastric cancer, and 0.1% develop mucosa associated lymphoid tissue (MALT) lymphoma
  • The changes caused by H. pylori infection in the stomach lining are strong risk factors for stomach cancer and MALT lymphoma
  • Studies* support an unequivocal role for H. pylori in the development of gastric cancer
  • There are several FDA approved chemotherapy drugs for stomach cancer

Novel anti-H. pylori therapies may be an effective means of gastric cancer prevention

Solstar Pharma Tactic

Develop new effective therapies against H. pylori

Research on traditional medicines and natural resources

  1. Develop antimicrobial agents with our VINE Formulation
  2. Protect against antibiotic resistance


Completely eradicate the infection

  1. Decrease ulcers and other symptoms
  2. Decrease risk of stomach cancer


Controlled release of novel agents using fast-action and slow-action formulation

  1. Decrease toxicity
  2. Reduce treatment dosages and period

Solutions for H. pylori infection

Learn more

References

  • Wroblewski LE, Peek RM, Wilson KT. Helicobacter pylori and Gastric Cancer: Factors That Modulate Disease Risk. Clinical Microbiology Reviews. 2010;23(4):713-739
  • Yuan Y, Ford AC, Khan KJ, Gisbert JP, Forman D, Leontiadis GI, Tse F, Calvet X, Fallone C, Fischbach L, Oderda G, Bazzoli F, Moayyedi P. Optimum duration of regimens for Helicobacter pylori eradication. Cochrane Database of Systematic Reviews 2013, Issue 12
  • Gatta, L; Vakil, N; Vaira, D; Scarpignato, C (7 August 2013). "Global eradication rates for Helicobacter pylori infection: systematic review and meta-analysis of sequential therapy.". BMJ (Clinical research ed.). 347: f4587
  • "The Nobel Prize in Physiology or Medicine 2005". Nobelprize.org. <http://www.nobelprize.org/nobel_prizes/medicine/laureates/2005/>