Probiotics-containing yogurts suppress Helicobacter pylori load and modify immune response and intestinal microbiota in the Helicobacter pylori-infected children.

BACKGROUND

The benefits of probiotics to the pediatric Helicobacter pylori infection remain uncertain. We tested whether the H. pylori-infected children have an altered gut microflora, and whether probiotics-containing yogurt can restore such change and improve their H. pylori-related immune cascades.

METHODS

We prospectively included 38 children with H. pylori infection confirmed by a positive ¹³C-urea breath test (UBT) and 38 age- and sex-matched noninfected controls. All of them have provided the serum and stool samples before and after 4-week ingestion of probiotics-containing yogurt. The serum samples were tested for the TNF-α, IL-10, IL-6, immunoglobulin (Ig) A, G, E, pepsinogens I and II levels. The stool samples were tested for the colony counts of Bifidobacterium spp. and Escherichia coli. The follow-up UBT indirectly assessed the H. pylori loads after yogurt usage.

RESULTS

The H. pylori-infected children had lower fecal Bifidobacterium spp. count (p = .009), Bifidobacterium spp./E. coli ratio (p = .04), serum IgA titer (p = .04), and pepsinogens I/II ratio (p < .001) than in controls. In the H. pylori-infected children, 4-week yogurt ingestion reduced the IL-6 level (p < .01) and H. pylori loads (p = .046), but elevated the serum IgA and pepsinogen II levels (p < .001). Moreover, yogurt ingestion can improve the childhood fecal Bifidobacterium spp./E. coli ratio (p = .03).

CONCLUSIONS

The H. pylori-infected children have a lower Bifidobacterium microflora in gut. The probiotics-containing yogurt can offer benefits to restore Bifidobacterium spp./E. coli ratio in children and suppress the H. pylori load with increment of serum IgA but with reduction in IL-6 in H. pylori-infected children.