Treatment of Helicobacter pylori infection with intra-gastric violet light phototherapy: a pilot clinical trial.
OBJECTIVE
Helicobacter pylori infects the mucus layer of the human stomach and causes peptic ulcers and adenocarcinoma. We have previously shown that H. pylori accumulates photoactive porphyrins making the organism susceptible to inactivation by light, and that small spot endoscopic illumination with violet light reduced bacterial load in human stomachs. This study assessed the feasibility and safety of whole-stomach intra-gastric violet phototherapy for the treatment of H. pylori infection.


METHODS
A controlled, prospective pilot trial was conducted using a novel light source consisting of laser diodes and diffusing fibers to deliver 408-nm illumination at escalating total fluences to the whole stomach. Eighteen adults (10 female) with H. pylori infection were treated at three U.S. academic endoscopy centers. Quantitative bacterial counts were obtained from biopsies taken from the antrum, body, and fundus, and serial urea breath tests.


RESULTS
The largest reduction in bacterial load was in the antrum (>97%), followed by body (>95%) and fundus (>86%). There was a correlation between log reduction and initial bacterial load in the antrum. There was no dose-response seen with increasing illumination times. The urea breath test results indicated that the bacteria repopulated in days following illumination.


CONCLUSIONS
Intra-gastric violet light phototherapy is feasible and safe and may represent a novel approach to eradication of H. pylori, particularly in patients who have failed standard antibiotic treatment. This was a pilot study involving a small number of patients. Further research is needed to determine if phototherapy can be effective for eradicating H. pylori.
Lembo
Anthony J
AJ
Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Ganz
Robert A
RA
Sheth
Sunil
S
Cave
David
D
Kelly
Ciaran
C
Levin
Philip
P
Kazlas
Peter T
PT
Baldwin
Paul C
PC
Lindmark
William R
WR
McGrath
Jonathan R
JR
Hamblin
Michael R
MR
D000328:Adult; D000368:Aged; D005260:Female; D016481:Helicobacter Infections / Q000628:therapy*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D010789:Phototherapy / Q000379:methods*; D010865:Pilot Projects; D011446:Prospective Studies; D055815:Young Adult