Abstract
BackgroundHelicobacter pylori infection has been associated with chronic gastritis, peptic ulcer and gastric carcinoma as over half of the world's population is colonized with this gram-negative bacterium. Due to the increasing antibiotic resistance, its eradication rates fails in a great portion of patients. A number of studies showed that molecules largely distributed in commonly consumed fruits and vegetables may have antimicrobial activity. The aim of the present study was to investigate the effect of bergamot juice (BJ) against Helicobacter pylori in vitro. The potential therapeutic combination between BJ and the antibiotics amoxicillin (AMX), clarithromycin (CLA) and metronidazole (MTZ) has also been evaluated.MethodsThe minimum inhibitory concentration (MIC) of BJ, AMX, CLA and MTZ against 2 ATCC and 32 clinical isolates of H. pylori was assayed according to CLSI. The checkerboard method was used to determine the efficacy of the association BJ with the three reference antibiotics.Killing curves were performed on the two cagA-positive ATCC strains of H. pylori (ATCC 43504 and ATCC 49503), on the clinical isolate cagA-positive HP6 strain of H. pylori and on the clinical isolate cagA-negative HP61 strain of H. pylori.ResultsBJ (2.5 %, v/v) inhibited the growth of 50 % of the H. pylori clinical isolates, whereas 5 % (v/v) inhibited 90 %. AMX was the most effective antibiotic against the reference strains and the clinical isolates, followed by CLA and MTZ. In the combination assays, synergism was observed between BJ and AMX and between BJ and MTZ against both the reference strains and the clinical isolates. Indifference was observed between BJ and CLA.ConclusionsBJ was effective in vitro against H. pylori and the genotype status of the clinical strains may have an impact on its susceptibility. The synergistic combination of BJ and antibiotics could be used to prevent or treat resistance.
Highlights
Helicobacter pylori infection has been associated with chronic gastritis, peptic ulcer and gastric carcinoma as over half of the world's population is colonized with this gram-negative bacterium
minimum inhibitory concentration (MIC) data were converted into fractional inhibitory concentration (FIC), defined as ratio of the concentration of the antimicrobial at an inhibitory concentration
The results reported in the present study demonstrated for the first time that bergamot juice (BJ) was effective against H. pylori strains, both alone or in combination with antibiotics
Summary
Helicobacter pylori infection has been associated with chronic gastritis, peptic ulcer and gastric carcinoma as over half of the world's population is colonized with this gram-negative bacterium. Infection with Helicobacter pylori (H. pylori), identified as group 1 carcinogen by the International Agency for Research on Cancer, has been associated with chronic gastritis, peptic ulcer and gastric carcinoma [1, 2]. Infection rates are similar for men and women and increase progressively with age. Despite the wide genetic diversity of H. pylori involved in its pathogenesis, a number of genetic loci, such as the cytotoxin-associated gene (cagA) and the vacuolating cytotoxin gene (vacA), have been identified. VacA, present in all H. pylori strains, contains two variable parts relevant to virulence [4], whereas cagA, not present in every H. pylori strain, is a marker for a pathogenicity island (PAI) [5]
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