益生菌對幽門桿菌除菌效益之應用

Application of Probiotics for the Control of H. pylori Infection

慢性幽門桿菌引發胃潰瘍、胃癌或胃淋巴癌，清除幽門桿菌可以降低這疾病，然而幽門桿菌的抗藥性逐年上升，雖使用新一代的抗生素、四合一及次序療法可以增加除菌的效果，仍然有價格及面臨未來接藥性的問題。益生菌透過調節免疫與非免疫的機制抑制幽門桿菌，不僅可以增加除菌的效果，並且能降低胃的發炎，對於一開始是否為高菌落量或抗藥性菌種仍有一致性的抑制效果。在孩童身上，慢性幽門桿菌感染會大量地影響其免疫反應，進而容易得胃癌、潰瘍、氣喘等免疫相關的疾病，並且影響整體表現。使用益生菌可以降低幽門桿菌菌落量，且可以及早回復道菌叢，值得運用於務防再次感染與預防新感染。

Chronic Helicobacter pylori infection leads to peptic ulcer, gastric cancer or lymphoma. H. pylori eradication can improve the control of peptic ulcer disease and reduce the risk of gastric carcinogenesis. However, the resistant strains of H. pylori are increasing. Although newly developed quinolone-based triple therapy, quadruple therapy or sequential therapy can overcome this problem now, we still face the problems of drug cost, compliance and resistant strains of H. pylori. Supplementation with probiotics in the first-line triple therapy and in the 2nd line therapy can improve the H. pylori eradication rate, and gastritis via immune and non-immune mechanisms. The positive effect of probiotics can be consistent for both sensitive and resistant H. pylori isolates, despite of the high bacterial loads. In the H. pylori-infected children, there would link with an imbalance of gut microbiota, potentially relevant to an impaired chronic immune responses related with peptic ulcer, asthma or even gastric cancer. Probiotics can suppress the H. pylori loads, modify the immune response, and restore the intestinal microbiota to improve children's immunity. Probiotics can also regulate gut microflora and immunity, and thus be promising to prevent the re-infection or new infection of H. pylori during long-term follow-up.