We have recently shown that, two years after H. pylori eradication, 30% of children became reinfected [38] therefore the possibility to reduce this phenomenon

by the simple administration of a probiotic is fascinating. H. pylori is known to suppress MUCI and MUC5A gene expression in a human gastric cell line [39]. In vitro studies have shown that L. plantarum strain 299v and L. rhamnosus GG increase the expression of MUC2 and MUC3 genes [40] and the subsequent extracellular secretion of mucin by colon cell cultures [41]. This property can mediate the ability of these strains to restore the mucosal permeability of gastric mucosa or inhibit the adherence of pathogenic Veliparib solubility dmso bacteria, including H. pylori [28]. Pantoflikova et al. have shown a significant increase of mucus thickness after long-term probiotic intake (L. jonhsonii Lj1) both in antrum and corpus [42]. The inflammatory response to H. pylori cause an increase of IL8 leading to release of TNFα and IL1–6 that stimulate CD4+ cells to produce IFNγ and IL4, -5, -6 that leads to gastric inflammation [43]. Probiotics could modify the

immune response of the host [28]. L. salivarius WB 1004 has shown in vitro to reduce IL-8 secretion by gastric epithelial cells [27] and in animal studies certain lactic acid bacteria (L. casei, L. acidophilus, L. rhamnosus, L. delbrueckii subsp. bulgaricus, L. plantarum, Lactococcus lactis and Streptococcus thermophilus) were been able to increase the number medchemexpress of IgA producing cells associated Acalabrutinib datasheet to the lamina propria of small intestine [44]. However, the specific interaction of probiotics with the immune system and the mechanism by which they can exert a beneficial effect are still unclear; moreover, the immunoadjuvant capacity observed would be a property of the strain assayed and can not be generalized to genus or species. The reduction of inflammation has been demonstrated

directly on gastric biopsies by Pantoflikova et al. [42] and indirectly by the decrease of serum gastrin-17 in H. pylori infected patients after probiotic dietetic supplementation [45] (L. jonhsonii Lj1 and L. rhamnosus GG, L. rhamnosus LC705, Propionibacterium freudenreichii JS, Bifidobacterium lactis Bb12, respectively). Recent studies have defined potentially new probiotic strains of L. reuteri, a small minority of which showed strong anti-inflammatory combined with anti-pathogen effects. L. reuteri ATCC PTA 6475 produces and exports substances that can interfere with TNFα production in human macrophages [46] and suppresses NFKB activation affecting apoptosis [47] whilst still retaining its basic anti-pathogen activity during both planktonic and biofilm growth [48]. Initial human studies on this strain in our clinic show good safety and tolerance (personal data). Clinical studies on a combination of the anti-inflammatory effects of this strain with the earlier known anti-H. pylori effect of L.