Progress in Use of Natural Products and Their Active Components against Helicobacter pylori

Abstract

Helicobacter pylori is considered the main etiological agent of gastritis, ulcers, and gastric carcinoma. It colonizes human gastric mucosa quite efficiently. Fifty % of the world population is actually infected. Since H. pylori discovery in 1982, it is well known the sensitivity of several H. pylori strains to a number of antibiotics when these are assayed in vitro. However, eradication therapies with a single antibacterial agent have failed. Recently, triple, quadruple, sequential, concomitant and hybrid therapies which include antibiotics and a proton pump inhibitor show improved eradication rate and low side effects. However, new problems have emerged. Anti-microbial resistance to the common antibiotics used has become a problem in both developed and developing countries. In particular, H. pylori clarithromycin-and metronidazole-resistant strains are a major problem in countries where H. pylori is highly prevalent. Thus, the widespread use of antibiotics is not economically feasible and might increase difficulties in the treatment of H. pylori. At present, there are no vaccines available in the market. As an alternative, effective non-antibiotic com-pounds should be highly desirable since their use may be safer and suitable to eradi-cate H. pylori. The first step in this direction has been to study the effect of medicinal herbs and natural products, such as green tea, ginseng, garlic, propolis, and probio-tics, then identify their active components such as polyphenols, antioxidants, purify them, and finally test them using in vitro and in vivo H. pylori growth assays. Some of them have been quite effective. The topics related to alternative therapies for H. pylori infections and current status of their use will be discussed in the present review.