Han Xiaoni, Liu Hui, Zhang Kaige, Zeng Yuyu, Liu Peng, Gan Lihong, Zheng Li, Liu Zhiguo, Fang Nian, Chen Tingtao
Department of Gynaecology and Obstetrics, Affiliated Rehabilitation Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi 330000, China.
Department of Gastroenterology, The Third Affiliated Hospital (The First Hospital of Nanchang), Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi 330000, China; Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, China.
J Infect. 2025 Jun 20;91(2):106539. doi: 10.1016/j.jinf.2025.106539.
Adverse events and microbiota dysbiosis resulting from Helicobacter pylori eradication therapy have become increasingly evident. This study aims to investigate the adjunctive therapeutic effects of Lactiplantibacillus plantarum MH-301 in H. pylori eradication therapy, as well as its effects on the gut and vaginal microbiota.
257 sexually active, premenopausal women aged 18-50 years, diagnosed with H. pylori infection alongside chronic gastritis, were randomly allocated to undergo either bismuth-containing quadruple therapy (amoxicillin, furazolidone, potassium bismuth citrate, rabeprazole) combined with probiotics (L. plantarum MH-301) or a placebo for 14 days. Stool samples and vaginal swabs were collected before and after treatment to facilitate high-throughput sequencing analysis.
The probiotic group exhibited lower incidences of bloating (10.2% vs 19.4%, P=0.037), constipation (2.3% vs 7.8%, P =0.048), and excessive vaginal discharge (3.1% vs 9.3%, P=0.040), and showed better treatment tolerability compared to the placebo group (P<0.05), although no statistically significant difference in eradication rates between the two groups. High-throughput sequencing revealed that H. pylori eradication therapy led to a decrease in the relative abundance of Prevotella in the gut microbiota, and an increase in Streptococcus and Haemophilus. In the vaginal microbiota, Lactobacillus decreased while Gardnerella increased. Compared to the placebo group, the probiotic group showed a higher relative abundance of Megamonas, Prevotella, and Lactobacillus in the gut microbiota, and lower levels of Streptococcus and Haemophilus. In the vaginal microbiota, Gardnerella was significantly lower (P<0.05). Correlation analysis revealed a positive association between gastrointestinal and vaginal adverse events, and a positive correlation of Lactobacillus in both gut and vaginal microbiota (P<0.05).
This study clinically demonstrates for the first time that L. plantarum MH - 301 may reduce H. pylori treatment - related adverse events via gut - vaginal axis. In addition, microbiota modulation may be the mechanism through which it exerts its clinical efficacy.
幽门螺杆菌根除治疗引起的不良事件和微生物群失调日益明显。本研究旨在探讨植物乳杆菌MH-301在幽门螺杆菌根除治疗中的辅助治疗效果及其对肠道和阴道微生物群的影响。
257名年龄在18至50岁之间、性活跃的绝经前女性，被诊断为幽门螺杆菌感染并伴有慢性胃炎，随机分配接受含铋四联疗法（阿莫西林、呋喃唑酮、枸橼酸铋钾、雷贝拉唑）联合益生菌（植物乳杆菌MH-301）或安慰剂治疗14天。在治疗前后收集粪便样本和阴道拭子，以进行高通量测序分析。
益生菌组腹胀（10.2%对19.4%，P=0.037）、便秘（2.3%对7.8%，P =0.048）和白带过多（3.1%对9.3%，P=0.040）的发生率较低，与安慰剂组相比显示出更好的治疗耐受性（P<0.05），尽管两组之间的根除率无统计学显著差异。高通量测序显示，幽门螺杆菌根除治疗导致肠道微生物群中普雷沃菌属的相对丰度降低，链球菌属和嗜血杆菌属增加。在阴道微生物群中，乳酸杆菌减少而加德纳菌增加。与安慰剂组相比，益生菌组肠道微生物群中巨单胞菌属、普雷沃菌属和乳酸杆菌属的相对丰度较高，链球菌属和嗜血杆菌属水平较低。在阴道微生物群中，加德纳菌显著较低（P<0.05）。相关性分析显示胃肠道和阴道不良事件之间呈正相关，肠道和阴道微生物群中的乳酸杆菌呈正相关（P<0.05）。
本研究首次在临床上证明，植物乳杆菌MH - 301可能通过肠-阴道轴减少幽门螺杆菌治疗相关的不良事件。此外，微生物群调节可能是其发挥临床疗效的机制。
