Effect of whey-based culture supernatant of Lactobacillus acidophilus (johnsonii) La1 on Helicobacter pylori infection in humans.
BACKGROUND
Specific strains of Lactobacillus acidophilus are known to inhibit intestinal cell adhesion and invasion by enterovirulent bacteria. As L. acidophilus can survive transiently in the human stomach, it may downregulate Helicobacter pylori infection.


METHODS
The ability of L. acidophilus (johnsonii) La1 supernatant to interfere with H. pylori bacterial growth, urease activity, and adhesion to epithelial cells was tested in vitro. Its effect on H. pylori infection in volunteers was monitored in a randomized, double-blind, controlled clinical trial, using a drinkable, whey-based, La1 culture supernatant. H. pylori infected volunteers were treated 14 days with 50 ml of La1 supernatant four times a day combined with either omeprazole 20 mg four times a day or with placebo. Infection was assessed by breath test, endoscopy, and biopsy sampling, performed at inclusion, immediately at the end of the treatment (breath test only), and 4 weeks after the end of the treatment.


RESULTS
La1 supernatant inhibited H. pylori growth in vitro, regardless of previous binding of H. pylori to epithelial cells. In 20 subjects (8 females, 12 males, mean age 33.1 years) a marked decrease in breath test values was observed immediately after treatment with La1 supernatant, both in the omeprazole and in the placebo group (median 12.3 vs. 28.8 and 9.4 vs. 20.4, respectively; p < 0.03). In both treatment groups, breath test values remained low 6 weeks after treatment (omeprazole treated 19.2, placebo treated 8. 3; p < 0.03 vs. pretreatment), but the persistence of H. pylori infection was confirmed in gastric biopsies.


CONCLUSIONS
La1 culture supernatant shown to be effective in vitro has a partial, acid-independent long-term suppressive effect on H. pylori in humans.
Michetti
P
P
Division of Gastroenterology, Department of Medicine, University Hospital, Lausanne, Switzerland. pmichett@bidmc.harvard.edu
Dorta
G
G
Wiesel
P H
PH
Brassart
D
D
Verdu
E
E
Herranz
M
M
Felley
C
C
Porta
N
N
Rouvet
M
M
Blum
A L
AL
Corthésy-Theulaz
I
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000032:analysis; D001422:Bacterial Adhesion; D001944:Breath Tests; D015169:Colony Count, Microbial; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000187:drug effects / Q000378:metabolism / Q000382:microbiology; D005756:Gastritis / Q000188:drug therapy / Q000378:metabolism / Q000382:microbiology*; D019073:HT29 Cells / Q000382:microbiology; D016481:Helicobacter Infections / Q000188:drug therapy / Q000378:metabolism / Q000382:microbiology*; D016480:Helicobacter pylori / Q000201:enzymology / Q000254:growth & development* / Q000276:immunology; D006801:Humans; D019344:Lactic Acid / Q000378:metabolism; D007779:Lactobacillus acidophilus / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000627:therapeutic use; D016896:Treatment Outcome; D014510:Urease / Q000378:metabolism
D000907:Antibodies, Bacterial; D019344:Lactic Acid; D014510:Urease; D009853:Omeprazole