- 1Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- 2Department of Clinical Medicine, School of Medicine, Trinity College Dublin, Dublin, Ireland
Editorial on the Research Topic
Helicobacter pylori infection and antibiotic resistance: clinical, translational and experimental studies
Helicobacter pylori (H. pylori) is a Gram-negative recalcitrant oncomicrobe that infects over half of the world’s population. Infection with H. pylori is the primary cause of gastric and duodenal ulcers and gastric malignancies (Malfertheiner et al., 2023). Current guidelines suggest the test-and-treat strategy, which is the antibiotic-based eradication of H. pylori upon diagnosis (Malfertheiner et al., 2022). However, the development of antibiotic resistance mechanisms and the subsequent emergence of single-drug and multi-drug resistant H. pylori strains have made the achievement of successful eradication extremely challenging (Tshibangu-Kabamba and Yamaoka, 2021). Therefore, monitoring antibiotic resistance, elucidating resistance mechanisms and developing innovative treatment approaches have become of significant interest in this field of study. In this regard, the Research Topic of “Helicobacter pylori infection and antibiotic resistance: clinical, translational and experimental studies” appeared highly topical, presenting novel insights on the critical challenge of H. pylori antibiotic resistance and prospective treatment strategies.
Given the growing body of research around H. pylori infection, Yu et al. analyzed H. pylori research hot topics over the past decade by performing a bibliometric and visual analysis. They meticulously elaborated on the increasing trend in H. pylori-related gastric ulcer research, with China being the most prolific country in terms of publications in this area and the United States as the most influential country. A cross-sectional study by Jiang et al. demonstrated an updated situation of H. pylori antibiotic resistance in China. Although analysis of 2109 H. pylori clinical isolates presented an overall reduction of primary resistance rate over the past years, H. pylori strains are as yet highly resistant to metronidazole (67.2%), clarithromycin (36.0%), and levofloxacin (24.2%). Considering the recommendation that clarithromycin susceptibility testing should be performed prior to prescribing any clarithromycin containing H. pylori first-line therapy (Malfertheiner et al., 2022), developing simple and more rapid techniques for detecting H. pylori clarithromycin resistance seems essential (Alavifard et al., 2023).
H. pylori infection is associated with significant alterations of the gastric microbial and metabolic profile (Fakharian et al., 2022). Successful eradication of H. pylori could considerably restore the indigenous structure of the gastric microbiota; however, refractory H. pylori infection and persistent administration of various antibiotics further disturb the host microbial profile. Liu et al. demonstrated that compared to the H. pylori-positive control group, refractory H. pylori infection contributes to the enrichment of infectious disease-associated metabolic pathways in the gastric microbiota, such as energy metabolism, lipopolysaccharide biosynthesis, glutathione metabolism, and sulphur metabolism. Refractory H. pylori infection mainly featured in the colonization resistance of beneficial Lactobacillus bacteria in the stomach. Given the supplementation of various beneficial bacterial strains (probiotics), mainly Lactobacillus bacteria, as adjunctive therapies for H. pylori eradication (Nabavi-Rad et al., 2022; Nabavi-Rad et al., 2023), Kiattiweerasak et al. investigated the efficacy of L. rhamnosus and L. helveticus administration for H. pylori eradication in a double-blind, randomized, placebo-controlled study. Despite the similar eradication rates between the probiotic and placebo groups, probiotic treatment substantially reduced drug-related side effects including bloating, diarrhea, nausea, and bitter taste. Furthermore, the probiotic group presented an elevation in general health-related quality of life.
In conclusion, the published studies in this Research Topic discussed the significant importance of H. pylori antibiotic resistance and its remarkable impact on the host gastric microbial structure. These studies further elaborated the potential for microbiome-based therapeutics in improving H. pylori treatment and health-related quality of life. Nevertheless, antibiotic resistance mechanisms of H. pylori are yet to be fully elucidated and require further in-depth investigation.
Author contributions
AY: Supervision, Writing – review & editing. AN-R: Writing – original draft. SS: Writing – review & editing.
Acknowledgments
We thank all of the authors involved in the Research Topic.
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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References
Alavifard, H., Nabavi-Rad, A., Baghaei, K., Sadeghi, A., Yadegar, A., Zali, M. R. (2023). Pyrosequencing analysis for rapid and accurate detection of clarithromycin resistance-associated mutations in Iranian Helicobacter pylori isolates. BMC Res. Notes 16 (1), 136. doi: 10.1186/s13104-023-06420-0
Fakharian, F., Asgari, B., Nabavi-Rad, A., Sadeghi, A., Soleimani, N., Yadegar, A., et al. (2022). The interplay between Helicobacter pylori and the gut microbiota: An emerging driver influencing the immune system homeostasis and gastric carcinogenesis. Front. Cell Infect. Microbiol. 12, 953718. doi: 10.3389/fcimb.2022.953718
Malfertheiner, P., Camargo, M. C., El-Omar, E., Liou, J.-M., Peek, R., Schulz, C., et al. (2023). Helicobacter pylori infection. Nat. Rev. Dis. Primers 9 (1), 19. doi: 10.1038/s41572-023-00431-8
Malfertheiner, P., Megraud, F., Rokkas, T., Gisbert, J. P., Liou, J. M., Schulz, C., et al. (2022). Management of Helicobacter pylori infection: the Maastricht VI/Florence consensus report. Gut 71, 1724–1762. doi: 10.1136/gutjnl-2022-327745
Nabavi-Rad, A., Jamshidizadeh, S., Azizi, M., Yadegar, A., Robinson, K., Monaghan, T. M., et al. (2023). The synergistic effect of Levilactobacillus brevis IBRC-M10790 and vitamin D3 on Helicobacter pylori-induced inflammation. Front. Cell Infect. Microbiol. 13, 1171469. doi: 10.3389/fcimb.2023.1171469
Nabavi-Rad, A., Sadeghi, A., Asadzadeh Aghdaei, H., Yadegar, A., Smith, S. M., Zali, M. R. (2022). The double-edged sword of probiotic supplementation on gut microbiota structure in Helicobacter pylori management. Gut Microbes 14 (1), 2108655. doi: 10.1080/19490976.2022.2108655
Keywords: Helicobacter pylori, antibiotic resistance, gastric microbiota, gastric ulcer, probiotic
Citation: Yadegar A, Nabavi-Rad A and Smith SM (2023) Editorial: Helicobacter pylori infection and antibiotic resistance: clinical, translational and experimental studies. Front. Cell. Infect. Microbiol. 13:1296784. doi: 10.3389/fcimb.2023.1296784
Received: 19 September 2023; Accepted: 25 September 2023;
Published: 02 October 2023.
Edited and Reviewed by:
Nahed Ismail, University of Illinois Chicago, United StatesCopyright © 2023 Yadegar, Nabavi-Rad and Smith. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Abbas Yadegar, YS55YWRlZ2FyQHNibXUuYWMuaXI=; YmFiYWtfeTE5ODNAeWFob28uY29t
†ORCID: Abbas Yadegar, orcid.org/0000-0002-2135-7581
Ali Nabavi-Rad, orcid.org/0000-0001-7799-9404
Sinéad Marian Smith, orcid.org/0000-0003-3460-3590