on May 28, Novozymes onehealth released pylopass ™ And the white paper on Helicobacter pylori, combed the relevant research progress and main consensus at home and abroad, summarized the existing scientific evidence for the diagnosis and treatment of Helicobacter pylori, and conducted in-depth analysis of its clinical research and diagnosis and treatment mechanism from an evidence-based perspective.
Highlights spoiler:
Highlight 1 scientific demonstration of Helicobacter pylori infection rate in the world and China
Highlight 2 industry sharing authority to interpret Helicobacter pylori prevention and treatment methods
Highlight 3 multi angle analysis of existing therapies and challenges of Helicobacter pylori
Highlight 4 key points for comprehensive analysis of clinical research on Helicobacter pylori
In recent years, the official attention to Helicobacter pylori has been increasing. From the major authoritative hospitals, Helicobacter pylori has been popularized to Helicobacter pylori detection as a physical examination project, and then to Jiangsu Province, where Helicobacter pylori family screening project has been launched, more and more people know and pay attention to Helicobacter pylori. However, various problems in the process of “understanding – Prevention – treatment” have also begun to appear.
According to relevant research data, China is a high incidence area of Helicobacter pylori infection, and nearly half of the new cases and deaths of gastric cancer in the world occur in China, which is closely related to the infection rate of Helicobacter pylori* Helicobacter pylori (HP) is a kind of gram-negative, microaerobic bacteria with unipolar, multi flagella, blunt round end and spiral curve. It is often colonized in human stomach and duodenum and has a significant impact on human health. Human research on HP can be traced back to the 19th century.
Research history of Helicobacter pylori
As early as 1892, Italian scholar Giulio Bizzozero discovered the existence of helicoid bacteria in the stomach. In 1906, Krienitz reported the colonization of spirochetes in human gastric epithelial cells. In 1982, Australian pathologist Barry Marshall and physician Robin Warren cooperated to successfully isolate and cultivate this spiral bacterium in the laboratory. With the discovery and continuous exploration of Helicobacter pylori, its possible harm to human body has also been widely concerned and known.
Figure: Barry Marshall (left) and Robin Warren (right) photo source: Official Website of Beijing Yousan balance Medical Research Institute
Helicobacter pylori is a common pathogen in the stomach, which is closely related to the occurrence of many gastrointestinal diseases. About 25~30% of the infected people may suffer from digestive discomfort, gastritis, peptic ulcer, gastric cancer and other gastrointestinal diseases. In 2015, the Kyoto global consensus on Helicobacter pylori gastritis (hereinafter referred to as the Kyoto consensus) clearly pointed out that Helicobacter pylori infection is the main cause of chronic gastritis. In December, 2021, the U.S. Department of health and human services issued the 15th edition of carcinogen report, adding Helicobacter pylori as a clear carcinogen.
Epidemiological investigation shows that infection with Helicobacter pylori can increase the risk of gastric cancer by 4-6 times, and the number of gastric cancer caused by Helicobacter pylori ranks in the forefront among the cancers caused by various infections. The Taipei global consensus on screening and eradication of Helicobacter pylori to prevent gastric cancer published in 2020 (hereinafter referred to as “the Taipei consensus”) holds that >85% of the world’s gastric cancer is attributed to Helicobacter pylori infection. The current accepted gastric cancer model believes that Helicobacter pylori infection drives the development process of normal gastric mucosa → chronic active gastritis → atrophic gastritis → intestinal metaplasia → dysplasia → gastric cancer. Eradicating Helicobacter pylori is equivalent to removing an initiating factor of gastric cancer.
Figure: Helicobacter pylori infection promotes the disease progression pattern of gastric cancer: chronic active gastritis occurs after Helicobacter pylori infection in normal gastric mucosa, and then develops into gastric cancer through progressive atrophic gastritis, intestinal metaplasia and dysplasia.
Source: Novozymes onehealth pylopass ™ And Helicobacter pylori white paper (pylopass ™ Lactobacillus reuteri DSM 17648)
Prevention and treatment of Helicobacter pylori
In order to reduce the harm of Helicobacter pylori to human health, most traditional methods rely on antibiotic therapy to eradicate Helicobacter pylori. But these methods also have some negative effects. For example, the antibiotic resistance of Helicobacter pylori is gradually increasing, and the success rate of antibiotic eradication treatment will continue to decline. Antibiotic treatment (especially repeated long-term use of antibiotics) also has potential impact on intestinal microecology.
Figure: primary treatment plan
of Helicobacter pylori involved in different consensus at home and abroad
Source: Novozymes onehealth pylopass ™ And Helicobacter pylori white paper (pylopass ™ Lactobacillus reuteri DSM 17648)
In order to deal with these problems and challenges, researchers are more inclined to look for other adjuvant and alternative therapies. As a microorganism beneficial to human health, the use of probiotics to intervene in the treatment of Helicobacter pylori infection is gradually becoming the choice and consensus of the scientific community. With the joint efforts of people, the infection rate of Helicobacter pylori in the world and China is declining over time, but at present, many people are still troubled by it.
Current status of Helicobacter pylori infection in the world and China
In 2017, Hong Kong scholars conducted a meta-analysis on the infection rate of Helicobacter pylori worldwide and in various regions. The analysis results showed that the overall infection rate of Helicobacter pylori worldwide was 48.7%, that is, nearly half of the global population was infected with Helicobacter pylori, and the infection rate of Helicobacter pylori in China was 55.8%.
Photo source: pylopass by Novozymes onehealth ™ And Helicobacter pylori white paper (pylopass ™ Lactobacillus reuteri DSM 17648)
Another meta-analysis published in 2018 analyzed the changes and influencing factors of the Helicobacter pylori infection rate after 2000. The results showed that the Helicobacter pylori infection rate in China was as high as 44.3%. In 2019, the Helicobacter pylori infection rate in China was 44.2%. Based on China’s 1.4 billion population, it is roughly estimated that the number of infected people in China may be as high as more than 600million.
Photo source: pylopass by Novozymes onehealth ™ And Helicobacter pylori white paper (pylopass ™ Lactobacillus reuteri DSM 17648)
The relevant meta-analysis in 2020 shows that the infection rate of Helicobacter pylori in adults in China is 49.6%, and there is a large difference between different regions (20.6~81.8%). The infection rate is different in urban and rural areas due to the difference of economic and health conditions. The infection rate of people under 30 years old and over 70 years old is slightly lower, and the infection rate of people aged 30-69 years old is more than 50%. In addition, in children and adolescents, the infection rate gradually increases with age. It is worth noting that there are significant differences in infection rates among different regions in China. Taking the northwest, southwest and eastern regions of China as examples, the infection rate is higher than 45%.
Photo source: pylopass by Novozymes onehealth ™ And Helicobacter pylori white paper (pylopass ™ Lactobacillus reuteri DSM 17648)
Based on the above background, onehealth, the human health department of Novozymes, a Danish biotechnology company, released pylopass on May 28 ™ And Helicobacter pylori white paper (pylopass ™ Lactobacillus reuteri DSM 17648), combined with years of clinical research validation and interpretation by well-known experts in the digestive field, combed the harm and current situation of Helicobacter pylori infection, prevention and treatment, relevant research progress and main consensus at home and abroad.
Highlight 1 scientific demonstration of Helicobacter pylori infection rate in the world and China
Photo source: pylopass by Novozymes onehealth ™ And Helicobacter pylori white paper (pylopass ™ Lactobacillus reuteri DSM 17648)
This white paper aims to sort out the history of Helicobacter pylori research, clarify the current situation of global Helicobacter pylori infection and regional characteristics, and deeply analyze the Chinese Helicobacter pylori research literature in combination with social and economic conditions, health level, region, age and other differentiated factors, and analyze the detailed data such as Helicobacter pylori infection rate, annual relapse rate and annual relapse rate in different regions, populations and ages, Identify the different characteristics of Helicobacter pylori infection caused by different factors, and provide clear, intuitive and rigorous industry analysis and data reference for enterprises and individuals committed to Helicobacter pylori prevention and control.
Photo source: pylopass by Novozymes onehealth ™ And Helicobacter pylori white paper (pylopass ™ Lactobacillus reuteri DSM 17648)
Highlight 2 industry sharing authority to interpret Helicobacter pylori prevention and treatment methods
Combined with a number of gastroenterologists to conduct integrated analysis on the top 10 consensus of Helicobacter pylori at home and abroad, and extract the key conclusions of each consensus on the harm and prevention of Helicobacter pylori. The consensus covers authoritative consensus such as the Kyoto consensus, the Ma five consensus and the national five consensus, as well as the consensus on collaborative diagnosis and treatment of traditional Chinese and Western medicine and the consensus on family prevention and control published in 2021, so as to provide a more comprehensive integrated analysis.
Highlight 3 multi angle analysis of existing therapies and challenges of Helicobacter pylori
Helicobacter pylori infection is related to a variety of digestive tract diseases, which need to be eradicated. Different diagnosis and treatment schemes such as powder, bismuth and non bismuth are compared in depth, and the main challenges are discussed.
Photo source: pylopass by Novozymes onehealth ™ And Helicobacter pylori white paper (pylopass ™ Lactobacillus reuteri DSM 17648)
Interpret the existing diagnosis and treatment schemes in combination with the authority of many digestive doctors, and explore the possibility of integrated traditional Chinese and Western medicine therapy and probiotic intervention. At the same time, it is proposed that the eradication rate of traditional Helicobacter pylori eradication programs is declining worldwide, and the treatment of Helicobacter pylori infection faces many challenges, including:
Highlight 4 key points for comprehensive analysis of clinical research on Helicobacter pylori
Based on the fact that the eradication rate of traditional Helicobacter pylori is decreasing and has a certain negative impact, people began to explore more natural therapies such as probiotics. In 2002, Dr. Christine Lang, a German pioneer in microbial research, led a team to screen a strain with significant binding effect with Helicobacter pylori: pylopass ™ (Lactobacillus reuteri dsm17648)
Through fluorescent labeling and massive controlled clinical trials, it is scientifically confirmed that this strain can reduce the value of Helicobacter pylori in patients. It can specifically recognize and combine the surface protein structure of Helicobacter pylori, so as to form a co polymer with Helicobacter pylori and expel it from the body through gastrointestinal peristalsis.
Pylopass ™ (Lactobacillus reuteri dsm17648) clinical research covers 6 countries including Germany, Ireland, Russia, Romania, China and India, with 12 clinical trials and 951 subjects in total
The following results were obtained from the validation:
Auxiliary use of pylopass ™ (Lactobacillus reuteri dsm17648) or its inactivating agent can reduce the infection load of Helicobacter pylori in children and adults, and significantly reduce the discomfort of antibiotic treatment. Use pylopass alone ™ (Lactobacillus reuteri dsm17648) or its inactivating agent can also improve the gastrointestinal discomfort of patients and regulate the composition of intestinal flora of patients.
Pylopass ™ (Lactobacillus reuteri dsm17648) binding to Helicobacter pylori:
① High affinity
② High specificity
③ Play a role in gastric juice environment
④ Inactivation does not affect its function
Pylopass ™ (Lactobacillus reuteri dsm17648) advantages:
① Or as a potential alternative to the treatment of Helicobacter pylori infection
② Compared with antibiotic therapy, the negative effects were significantly less
③ Long term administration (such as lasting for 8 weeks) may improve the eradication rate to close to the effect of antibiotic treatment.
④ Combined with antibiotic therapy, it also has obvious effect in improving symptoms and alleviating discomfort reactions, and can further improve the eradication rate.
Photo source: pylopass by Novozymes onehealth ™ And Helicobacter pylori white paper (pylopass ™ Lactobacillus reuteri DSM 17648)
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To sum up, pylopass ™ (L. reuteri DSM 17648) or can be used as an adjuvant therapy for the treatment of Helicobacter pylori infection and its related diseases (such as functional dyspepsia) and may be used as an alternative therapy in groups not suitable for antibiotic treatment, but further research is needed.
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