Department of Obstetrics and Gynecology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, 330006, China.
Queen Mary School, Jiangxi Medical College, Nanchang University, Nanchang, 330031, China.
NPJ Biofilms Microbiomes. 2024 Jun 20;10(1):49. doi: 10.1038/s41522-024-00521-9.
Helicobacter pylori is a prevalent bacterial pathogen globally, implicated in various gastrointestinal disorders. Current recommended antibiotic therapies for H. pylori infection have been proven to be therapeutically insufficient, with low eradication rates and high recurrence rates. Emerging evidence suggests that antibiotic therapy for H. pylori can lead to gastrointestinal and subsequent vaginal dysbiosis, posing challenges for conventional antibiotic approaches. Thus, this article proposes a novel probiotic therapy involving simultaneous oral and intra-vaginal probiotic administration alongside antibiotics for H. pylori treatment, aiming to enhance eradication rates and mitigate dysbiosis. We begin by providing an overview of gastrointestinal and vaginal microbiota and their interconnectedness through the vagina-gut axis. We then review the efficacy of current antibiotic regimens for H. pylori and discuss how antibiotic treatment impacts the vaginal microenvironment. To explore the feasibility of this approach, we evaluate the effectiveness of oral and intra-vaginal probiotics in restoring normal microbiota in the gastrointestinal and vaginal tracts, respectively. Additionally, we analyze the direct mechanisms by which oral and intra-vaginal probiotics act on their respective tracts and discuss potential cross-tract mechanisms. Considering the potential synergistic therapeutic effects of probiotics in both the gastrointestinal and vaginal tracts, dual-channel probiotic therapy holds promise as a more effective approach for H. pylori eradication and dysbiosis mitigation, presenting a novel concept in the collaborative treatment of gastrointestinal and genital disorders.
幽门螺杆菌是一种全球流行的细菌病原体，与各种胃肠道疾病有关。目前推荐的用于治疗幽门螺杆菌感染的抗生素疗法已被证明在治疗上是不够的，其根除率低，复发率高。新出现的证据表明，幽门螺杆菌的抗生素治疗可能导致胃肠道和随后的阴道菌群失调，这对传统的抗生素方法提出了挑战。因此，本文提出了一种新的益生菌治疗方法，即在抗生素治疗幽门螺杆菌的同时，进行口服和阴道内益生菌联合治疗，以提高根除率并减轻菌群失调。我们首先概述了胃肠道和阴道微生物群及其通过阴道-肠道轴的相互联系。然后，我们回顾了目前用于治疗幽门螺杆菌的抗生素方案的疗效，并讨论了抗生素治疗如何影响阴道微环境。为了探讨这种方法的可行性，我们评估了口服和阴道内益生菌在分别恢复胃肠道和阴道正常微生物群中的有效性。此外，我们分析了口服和阴道内益生菌在各自部位的直接作用机制，并讨论了潜在的跨部位机制。考虑到益生菌在胃肠道和阴道中的协同治疗效果，双通道益生菌治疗作为一种更有效的幽门螺杆菌根除和减轻菌群失调的方法具有很大的潜力，为胃肠道和生殖器疾病的协同治疗提供了一个新的概念。
