medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2017-5-80-84medsovet-1797Research ArticleГАСТРОЭНТЕРОЛОГИЯGASTROENTEROLOGYРОЛЬ ПРОБИОТИКОВ В ЛЕЧЕНИИ HELICOBACTER PYLORI-АССОЦИИРОВАННЫХ ЗАБОЛЕВАНИЙTHE ROLE OF PROBIOTICS IN THE TREATMENT OF HELICOBACTER PYLORI ASSOCIATED DISEASESПлотниковаЕ. Ю.PlotnikovaE. Y.

Доктор медицинских наук, профессор

MD, Prof.

ГрачеваТ. Ю.GrachevaT. Y.

Доктор медицинских наук, профессор

MD, Prof

Кемеровский государственный медицинский университет Минздрава РФРоссияKemerovo State Medical University, Russia’s Ministry of HealthRussian Federation201711052017058084Copyright © Плотникова Е.Ю., Грачева Т.Ю., 20172017Плотникова Е.Ю., Грачева Т.Ю.Plotnikova E.Y., Gracheva T.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/1797

Helicobacterpylori (Hр) является распространенным  грамотрицательным,  жгутиковым спиральным  микроорганизмом, инфицирующим слизистую оболочку желудка. В 1994  г. Международное агенство по изучению рака включило  H. pylori в список канцерогенов первой группы. Терапевтические варианты лечения инфекции, вызванной бактерией H. pylori, направленные на полное ее уничтожение,  включают в себя различные сочетания ингибиторов протонного насоса совместно с двумя или тремя антибиотиками. Такой комплексный подход обладает по своему существу высокими рисками возникновения побочных эффектов и несоблюдения лечения. Согласно Маастрихтскому соглашению с целью снижения риска побочных эффектов на микробиоценоз ЖКТ и повышения эффективности эрадикации целесообразно добавление пробиотиков в схемы эрадикации. Доказана способность некоторых штаммов пробиотиков вызывать эрадикацию при монотерапии. Тем не менее при анализе данных в подгруппах  лишь некоторые штаммы сохраняли  клиническую значимость, в т. ч. различные штаммы рода Lactobacillus. Штамм LасtobacillusreuteriDSMZ17648 (субстанция Pylopass, входит в состав торгового наименования Хелинорм) показывает снижение уровня колонизации  H. pylori и может использоваться в схеме эрадикационной терапии с целью повышения ее эффективности и безопасности.

Helicobacter pylori (Hp) is a widespread gram-negative, spiral microorganism with flagella that infects the stomach lining. In 1994, the International Agency for Research on Cancer included H. pylori in the list of group 1 carcinogens. Therapeutic options for the treatment of infections caused by H. pylori and aimed at its complete eradication include various combinations of a proton pump inhibitor with two or three antibiotics. This integrated approach is basically associated with a high risk of side effects and non-compliance with treatment. According to the 5 Maastricht Treaty, in order to reduce the risk of side effects on the gastrointestinal tract microbiocenosis and increase the eradication efficacy, it is recommended to complement eradication schemes with probiotics. The ability of certain strains of probiotics to promote eradication during monotherapy has been proved. However, the analysis of findings in subgroups showed that only certain strains including different strains of Lactobacillus could maintain clinical significance. Lactobacillus reuteri DSMZ17648 (Pylopass, a part of the Helinorm trade name) demonstrated a decrease in the level of H. pylori colonization and can be used in eradication schemes to enhance the effectiveness and safety of treatment.

Helicobacter pyloriпробиотикиантихеликобактерная терапияХелинорм.Helicobacter pyloriprobioticsanti-Helicobacter pylori therapyHelinormReferencesBoltin D. Probiotics in Helicobacter pyloriinduced peptic ulcer disease. Clinical gastroenterology, 2016, 30(1): 99–109.Boltin D. Probiotics in Helicobacter pyloriinduced peptic ulcer disease. Clinical gastroenterology, 2016, 30(1): 99–109.Ianiro G, Molina-Infante J, and Gasbarrini A. Gastric microbiota. Helicobacter, 2015, 20: 68–71.Ianiro G, Molina-Infante J, and Gasbarrini A. Gastric microbiota. Helicobacter, 2015, 20: 68–71.Delgado S, Cabrera-Rubio R, Mira A, Suárez A and Mayo B. Microbiological survey of the human gastric ecosystem using culturing and pyrosequencing methods. Microb Ecol., 2013, 65: 763–772.Delgado S, Cabrera-Rubio R, Mira A, Suárez A and Mayo B. Microbiological survey of the human gastric ecosystem using culturing and pyrosequencing methods. Microb Ecol., 2013, 65: 763–772.Andersson AF, Lindberg M, Jakobsson H, Bäckhed F, Nyrén P and Engstrand L. Comparative analysis of human gut microbiota by barcoded pyrosequencing. PLoS One, 2008, 3: e2836.Andersson AF, Lindberg M, Jakobsson H, Bäckhed F, Nyrén P and Engstrand L. Comparative analysis of human gut microbiota by barcoded pyrosequencing. PLoS One, 2008, 3: e2836.Bik EM, Eckburg PB, Gill SR, Nelson KE, Purdom EA, Francois F et al. Molecular analysis of the bacterial microbiota in the human stomach. Proc Natl Acad Sci USA, 2006, 103: 732–737.Bik EM, Eckburg PB, Gill SR, Nelson KE, Purdom EA, Francois F et al. Molecular analysis of the bacterial microbiota in the human stomach. Proc Natl Acad Sci USA, 2006, 103: 732–737.Li X, Wong GL, To K, Wong VW, Lai LH, Chow DK et al. Bacterial microbiota profiling in gastritis without Helicobacter pylori infection or non-steroidal anti-inflammatory drug use. PLoS One, 2009, 4(e7985).Li X, Wong GL, To K, Wong VW, Lai LH, Chow DK et al. Bacterial microbiota profiling in gastritis without Helicobacter pylori infection or non-steroidal anti-inflammatory drug use. PLoS One, 2009, 4(e7985).Saxelin M, Tynkkynen S, Mattila-Sandholm T and de Vos, W.M. Probiotic and other functional microbes: from markets to mechanisms. Curr Opin Biotechnol, 2005, 16: 204–211.Saxelin M, Tynkkynen S, Mattila-Sandholm T and de Vos, W.M. Probiotic and other functional microbes: from markets to mechanisms. Curr Opin Biotechnol, 2005, 16: 204–211.Saha A, Hammond CE, Beeson C, Peek RM, and Smolka AJ. Helicobacter pylori represses proton pump expression and inhibits acid secretion in human gastric mucosa. Gut, 2010, 59: 874–881.Saha A, Hammond CE, Beeson C, Peek RM, and Smolka AJ. Helicobacter pylori represses proton pump expression and inhibits acid secretion in human gastric mucosa. Gut, 2010, 59: 874–881.Schepp W, Dehne K, Herrmuth H, Pfeffer K and Prinz C. Identification and functional importance of IL-1 receptors on rat parietal cells. Am J Physiol, 1998, 275: G1094–G1105.Schepp W, Dehne K, Herrmuth H, Pfeffer K and Prinz C. Identification and functional importance of IL-1 receptors on rat parietal cells. Am J Physiol, 1998, 275: G1094–G1105.Celli JP, Turner BS, Afdhal NH, Keates S, Ghiran I, Kelly CP et al. Helicobacter pylori moves through mucus by reducing mucin viscoelasticity. Proc Natl Acad Sci USA, 2009, 106: 1432.Celli JP, Turner BS, Afdhal NH, Keates S, Ghiran I, Kelly CP et al. Helicobacter pylori moves through mucus by reducing mucin viscoelasticity. Proc Natl Acad Sci USA, 2009, 106: 1432.Bovenkamp Van de, Jeroen HB, Mahdavi J, Korteland-Van Male AM, Büller HA, Einerhand AWC et al. The MUC5AC glycoprotein is the primary receptor for Helicobacter pylori in the human stomach. Helicobacter, 2003, 8: 521–532.Bovenkamp Van de, Jeroen HB, Mahdavi J, Korteland-Van Male AM, Büller HA, Einerhand AWC et al. The MUC5AC glycoprotein is the primary receptor for Helicobacter pylori in the human stomach. Helicobacter, 2003, 8: 521–532.Tanaka S, Mizuno M, Maga T, Yoshinaga F, Tomoda J, Nasu J et al. H. pylori decreases gastric mucin synthesis via inhibition of galactosyltransferase. Hepatogastroenterology, 2003, 50: 1739–1742.Tanaka S, Mizuno M, Maga T, Yoshinaga F, Tomoda J, Nasu J et al. H. pylori decreases gastric mucin synthesis via inhibition of galactosyltransferase. Hepatogastroenterology, 2003, 50: 1739–1742.Peterson AJ, Menheniott TR, O’Connor L, Walduck AK, Fox JG, Kawakami K et al. Helicobacter pylori infection promotes methylation and silencing of trefoil factor 2, leading to gastric tumor development in mice and humans. Gastroenterology, 2010, 139: 2005–2017.Peterson AJ, Menheniott TR, O’Connor L, Walduck AK, Fox JG, Kawakami K et al. Helicobacter pylori infection promotes methylation and silencing of trefoil factor 2, leading to gastric tumor development in mice and humans. Gastroenterology, 2010, 139: 2005–2017.Nakayama M, Kimura M, Wada A, Yahiro K, Ogushi K, Niidome T et al. Helicobacter pylori VacA activates the p38/activating transcription factor 2-mediated signal pathway in AZ-521 cells. J Biol Chem., 2004, 279: 7024–7028.Nakayama M, Kimura M, Wada A, Yahiro K, Ogushi K, Niidome T et al. Helicobacter pylori VacA activates the p38/activating transcription factor 2-mediated signal pathway in AZ-521 cells. J Biol Chem., 2004, 279: 7024–7028.Guruge JL, Falk PG, Lorens RG, Dans M, With НР, Blaser MJ, Berg DE, Gordon JI. Epithelial attachment alters the outcome of Helicobacter pylori infection. Proc. Nalt. Acad. Sci. USA., 1998, Mar, 31, 95(7): 3925-30.Guruge JL, Falk PG, Lorens RG, Dans M, With НР, Blaser MJ, Berg DE, Gordon JI. Epithelial attachment alters the outcome of Helicobacter pylori infection. Proc. Nalt. Acad. Sci. USA., 1998, Mar, 31, 95(7): 3925-30.Yang Y, Chuang C, Yang H, Lu C and Sheu B. Lactobacillus acidophilus ameliorates H. pyloriinduced gastric inflammation by inactivating the Smad7 and NFκB pathways. BMC Microbiol., 2012, 12: 38.Yang Y, Chuang C, Yang H, Lu C and Sheu B. Lactobacillus acidophilus ameliorates H. pyloriinduced gastric inflammation by inactivating the Smad7 and NFκB pathways. BMC Microbiol., 2012, 12: 38.Yu H, Liu W, Chang Z, Shen H, He L, Wang S et al. Probiotic BIFICO cocktail ameliorates Helicobacter pylori induced gastritis. World J Gastroenterol., 2015, 21: 6561–6571.Yu H, Liu W, Chang Z, Shen H, He L, Wang S et al. Probiotic BIFICO cocktail ameliorates Helicobacter pylori induced gastritis. World J Gastroenterol., 2015, 21: 6561–6571.Keersmaecker De Sigrid CJ, Verhoeven TLA, Desair J, Marchal K, Vanderleyden J et al. Strong antimicrobial activity of Lactobacillus rhamnosus GG against Salmonella typhimurium is due to accumulation of lactic acid. FEMS Microbiol Lett., 2006, 259: 89–96.Keersmaecker De Sigrid CJ, Verhoeven TLA, Desair J, Marchal K, Vanderleyden J et al. Strong antimicrobial activity of Lactobacillus rhamnosus GG against Salmonella typhimurium is due to accumulation of lactic acid. FEMS Microbiol Lett., 2006, 259: 89–96.Cunningham-Rundles S, Ahrne S, Bengmark S, Johann-Liang R, Marshall F, Metakis L et al. Probiotics and immune response. Am J Gastroenterol., 2000, 95: S22–5.Cunningham-Rundles S, Ahrne S, Bengmark S, Johann-Liang R, Marshall F, Metakis L et al. Probiotics and immune response. Am J Gastroenterol., 2000, 95: S22–5.Mack DR, Michail S, Wei S, McDougall L and Hollingsworth MA. Probiotics inhibit enteropathogenic E. coli adherence in vitro by inducing intestinal mucin gene expression. Am J Physiol., 1999, 276: G941–G950.Mack DR, Michail S, Wei S, McDougall L and Hollingsworth MA. Probiotics inhibit enteropathogenic E. coli adherence in vitro by inducing intestinal mucin gene expression. Am J Physiol., 1999, 276: G941–G950.Coconnier MH, Lievin V, Hemery E and Servin AL. Antagonistic activity against Helicobacter infection in vitro and in vivo by the human Lactobacillus acidophilus strain LB. Appl Environ Microbiol., 1998, 64: 4573–4580.Coconnier MH, Lievin V, Hemery E and Servin AL. Antagonistic activity against Helicobacter infection in vitro and in vivo by the human Lactobacillus acidophilus strain LB. Appl Environ Microbiol., 1998, 64: 4573–4580.Valeur N, Engel P, Carbajal N, Connolly E and Ladefoged K. Colonization and Immunomodulation by lactobacillus reuteri ATCC 55730 in the human gastrointestinal tract. Appl Environ Microbiol., 2004, 70: 1176–1181.Valeur N, Engel P, Carbajal N, Connolly E and Ladefoged K. Colonization and Immunomodulation by lactobacillus reuteri ATCC 55730 in the human gastrointestinal tract. Appl Environ Microbiol., 2004, 70: 1176–1181.Felley CP, Corthesy-Theulaz I, Rivero JL, Sipponen P, Kaufmann M, Bauerfeind P et al. Favourable effect of an acidified milk (LC-1) on Helicobacter pylori gastritis in man. Eur J Gastroenterol Hepatol., 2001, 13: 25–29.Felley CP, Corthesy-Theulaz I, Rivero JL, Sipponen P, Kaufmann M, Bauerfeind P et al. Favourable effect of an acidified milk (LC-1) on Helicobacter pylori gastritis in man. Eur J Gastroenterol Hepatol., 2001, 13: 25–29.Conway PL and Kjelleberg S. Protein-mediated adhesion of Lactobacillus fermentum strain 737 to mouse stomach squamous epithelium. J Gen Microbiol., 1989, 135: 1175–1186.Conway PL and Kjelleberg S. Protein-mediated adhesion of Lactobacillus fermentum strain 737 to mouse stomach squamous epithelium. J Gen Microbiol., 1989, 135: 1175–1186.Spinler JK, Taweechotipatr M, Rognerud CL, Ou CN, Tumwasorn S, and Versalovic J. Human-derived probiotic Lactobacillus reuteri demonstrate antimicrobial activities targeting diverse enteric bacterial pathogens. Anaerobe, 2008, 14: 166–171.Spinler JK, Taweechotipatr M, Rognerud CL, Ou CN, Tumwasorn S, and Versalovic J. Human-derived probiotic Lactobacillus reuteri demonstrate antimicrobial activities targeting diverse enteric bacterial pathogens. Anaerobe, 2008, 14: 166–171.Aiba Y, Nakano Y, Koga Y, Takahashi K and Komatsu Y. A highly acid-resistant novel strain of Lactobacillus johnsonii No. 1088 has antibacterial activity, including that against Helicobacter pylori, and inhibits gastrin-mediated acid production in mice. Microbiologyopen, 2015, 4: 465–474.Aiba Y, Nakano Y, Koga Y, Takahashi K and Komatsu Y. A highly acid-resistant novel strain of Lactobacillus johnsonii No. 1088 has antibacterial activity, including that against Helicobacter pylori, and inhibits gastrin-mediated acid production in mice. Microbiologyopen, 2015, 4: 465–474.Rugge M, Correa P, Di Mario F, El-Omar E, Fiocca R, Geboes K et al. OLGA staging for gastritis: a tutorial. Dig Liver Dis, 2008, 40: 650–658.Rugge M, Correa P, Di Mario F, El-Omar E, Fiocca R, Geboes K et al. OLGA staging for gastritis: a tutorial. Dig Liver Dis, 2008, 40: 650–658.Felley CP, Corthesy-Theulaz I, Rivero JL, Sipponen P, Kaufmann M, Bauerfeind P et al. Favourable effect of an acidified milk (LC-1) on Helicobacter pylori gastritis in man. Eur J Gastroenterol Hepatol, 2001, 13: 25–29.Felley CP, Corthesy-Theulaz I, Rivero JL, Sipponen P, Kaufmann M, Bauerfeind P et al. Favourable effect of an acidified milk (LC-1) on Helicobacter pylori gastritis in man. Eur J Gastroenterol Hepatol, 2001, 13: 25–29.Francavilla R, Lionetti E, Castellaneta SP, Magistà AM, Maurogiovanni G, Bucci N et al. Inhibition of Helicobacter pylori infection in humans by Lactobacillus reuteri ATCC 55730 and effect on eradication therapy: a pilot study. Helicobacter, 2008, 13: 127–134.Francavilla R, Lionetti E, Castellaneta SP, Magistà AM, Maurogiovanni G, Bucci N et al. Inhibition of Helicobacter pylori infection in humans by Lactobacillus reuteri ATCC 55730 and effect on eradication therapy: a pilot study. Helicobacter, 2008, 13: 127–134.Pantoflickova D, Corthésy-Theulaz I, Dorta G, Stolte M, Isler P, Rochat F et al. Favourable effect of regular intake of fermented milk containing Lactobacillus johnsonii on Helicobacter pylori associated gastritis. Aliment Pharmacol Ther., 2003, 18: 805–813.Pantoflickova D, Corthésy-Theulaz I, Dorta G, Stolte M, Isler P, Rochat F et al. Favourable effect of regular intake of fermented milk containing Lactobacillus johnsonii on Helicobacter pylori associated gastritis. Aliment Pharmacol Ther., 2003, 18: 805–813.Tong JL, Ran ZH, Shen J, Zhang CX and Xiao SD. Meta-analysis: the effect of supplementation with probiotics on eradication rates and adverse events during Helicobacter pylori eradication therapy. Aliment Pharmacol Ther., 2007, 25: 155–168.Tong JL, Ran ZH, Shen J, Zhang CX and Xiao SD. Meta-analysis: the effect of supplementation with probiotics on eradication rates and adverse events during Helicobacter pylori eradication therapy. Aliment Pharmacol Ther., 2007, 25: 155–168.Zou J, Dong J and Yu X. Meta-analysis: Lactobacillus containing quadruple therapy versus standard triple first-line therapy for Helicobacter pylori eradication. Helicobacter, 2009, 14: 97–107.Zou J, Dong J and Yu X. Meta-analysis: Lactobacillus containing quadruple therapy versus standard triple first-line therapy for Helicobacter pylori eradication. Helicobacter, 2009, 14: 97–107.Sachdeva A and Nagpal J. Effect of fermented milk-based probiotic preparations on Helicobacter pylori eradication: a systematic review and meta-analysis of randomized-controlled trials. Eur J Gastroenterol Hepatol., 2009, 21: 45–53.Sachdeva A and Nagpal J. Effect of fermented milk-based probiotic preparations on Helicobacter pylori eradication: a systematic review and meta-analysis of randomized-controlled trials. Eur J Gastroenterol Hepatol., 2009, 21: 45–53.Szajewska H, Horvath A and Piwowarczyk A. Metaanalysis: the effects of Saccharomyces boulardii supplementation on Helicobacter pylori eradication rates and side effects during treatment. Aliment Pharmacol Ther., 2010, 32: 1069–1079.Szajewska H, Horvath A and Piwowarczyk A. Metaanalysis: the effects of Saccharomyces boulardii supplementation on Helicobacter pylori eradication rates and side effects during treatment. Aliment Pharmacol Ther., 2010, 32: 1069–1079.Wang Z, Gao Q and Fang J. Meta-analysis of the efficacy and safety of Lactobacillus-containing and Bifidobacterium-containing probiotic compound preparation in Helicobacter pylori eradication therapy. J Clin Gastroenterol., 2013, 47: 25–32.Wang Z, Gao Q and Fang J. Meta-analysis of the efficacy and safety of Lactobacillus-containing and Bifidobacterium-containing probiotic compound preparation in Helicobacter pylori eradication therapy. J Clin Gastroenterol., 2013, 47: 25–32.Zheng X, Lyu L and Mei Z. Lactobacilluscontaining probiotic supplementation increases Helicobacter pylori eradication rate: evidence from a meta-analysis. Rev Esp Enferm Dig., 2013, 105: 445–453.Zheng X, Lyu L and Mei Z. Lactobacilluscontaining probiotic supplementation increases Helicobacter pylori eradication rate: evidence from a meta-analysis. Rev Esp Enferm Dig., 2013, 105: 445–453.Li S, Huang X, Sui J, Chen S, Xie Y, Deng Y et al. Meta-analysis of randomized controlled trials on the efficacy of probiotics in Helicobacter pylori eradication therapy in children. Eur J Pediatr., 2014, 173: 153–161.Li S, Huang X, Sui J, Chen S, Xie Y, Deng Y et al. Meta-analysis of randomized controlled trials on the efficacy of probiotics in Helicobacter pylori eradication therapy in children. Eur J Pediatr., 2014, 173: 153–161.Dang Y, Reinhardt JD, Zhou X and Zhang G. The effect of probiotics supplementation on Helicobacter pylori eradication rates and side effects during eradication therapy: a metaanalysis. PLoS One, 2014, 9: e111030.Dang Y, Reinhardt JD, Zhou X and Zhang G. The effect of probiotics supplementation on Helicobacter pylori eradication rates and side effects during eradication therapy: a metaanalysis. PLoS One, 2014, 9: e111030.Zhu R, Chen K, Zheng Y, Zhang H, Wang J, Xia Y et al. Meta-analysis of the efficacy of probiotics in Helicobacter pylori eradication therapy. World J Gastroenterol., 2014, 20: 18013–18021.Zhu R, Chen K, Zheng Y, Zhang H, Wang J, Xia Y et al. Meta-analysis of the efficacy of probiotics in Helicobacter pylori eradication therapy. World J Gastroenterol., 2014, 20: 18013–18021.Zhang M, Qian W, Qin Y, He J and Zhou Y. Probiotics in Helicobacter pylori eradication therapy: a systematic review and meta-analysis. World J Gastroenterol., 2015, 21: 4345–4357.Zhang M, Qian W, Qin Y, He J and Zhou Y. Probiotics in Helicobacter pylori eradication therapy: a systematic review and meta-analysis. World J Gastroenterol., 2015, 21: 4345–4357.Gong Y, Li Y and Sun Q. Probiotics improve efficacy and tolerability of triple therapy to eradicate Helicobacter pylori: a meta-analysis of randomized controlled trials. Int J Clin Exp Med., 2015, 8: 6530–6543Gong Y, Li Y and Sun Q. Probiotics improve efficacy and tolerability of triple therapy to eradicate Helicobacter pylori: a meta-analysis of randomized controlled trials. Int J Clin Exp Med., 2015, 8: 6530–6543Tyagi AK, Prasad S. Commentary: Probiotic and technological properties of Lactobacillus spp. strains from the human stomach in the search for potential candidates against gastric microbial dysbiosis. Front. Microbiol., 2014, 5: 766.Tyagi AK, Prasad S. Commentary: Probiotic and technological properties of Lactobacillus spp. strains from the human stomach in the search for potential candidates against gastric microbial dysbiosis. Front. Microbiol., 2014, 5: 766.Li B, Threapleton DE, Wang J, Xu J, Yuan J, Zhang C et al. Comparative effectiveness and tolerance of treatments for Helicobacter pylori: systematic review and network meta-analysis. BMJ, 2015, 351(h4052).Li B, Threapleton DE, Wang J, Xu J, Yuan J, Zhang C et al. Comparative effectiveness and tolerance of treatments for Helicobacter pylori: systematic review and network meta-analysis. BMJ, 2015, 351(h4052).Dore MP, Cuccu M, Pes GM, Manca A, Graham DY. Lactobacillus reuteri in the treatment of Helicobacter pylori infection. Intern Emerg Med., 2014, 9(6): 649-54.Dore MP, Cuccu M, Pes GM, Manca A, Graham DY. Lactobacillus reuteri in the treatment of Helicobacter pylori infection. Intern Emerg Med., 2014, 9(6): 649-54.Emara MH, Mohamed SY, Abdel-Aziz HR. Lactobacillus reuteri in management of Helicobacter pylori infection in dyspeptic patients: a doubleblind placebo-controlled randomized clinical trial. Therap Adv Gastroenterol., 2014, 7(1): 4-13.Emara MH, Mohamed SY, Abdel-Aziz HR. Lactobacillus reuteri in management of Helicobacter pylori infection in dyspeptic patients: a doubleblind placebo-controlled randomized clinical trial. Therap Adv Gastroenterol., 2014, 7(1): 4-13.Lee YC, Chiang TH, Chou CK et al. Association Between Helicobacter pylori Eradication and Gastric Cancer Incidence: A Systematic Review and Meta-analysis. Gastroenterology, 2016, 150(5): 1113-24.Lee YC, Chiang TH, Chou CK et al. Association Between Helicobacter pylori Eradication and Gastric Cancer Incidence: A Systematic Review and Meta-analysis. Gastroenterology, 2016, 150(5): 1113-24.Mehling H, Busjahn A. Non-Viable Lactobacillus reuteri DSMZ 17648 (Pylopass™) as a New Approach to Helicobacter pylori Control in Humans. Nutrients, 2013, 5(8): 3062-3073.Mehling H, Busjahn A. Non-Viable Lactobacillus reuteri DSMZ 17648 (Pylopass™) as a New Approach to Helicobacter pylori Control in Humans. Nutrients, 2013, 5(8): 3062-3073.Holz C, Busjahn A, Mehling H et al. Significant Reduction in Helicobacter pylori Load in Humans with Non-viable Lactobacillus reuteri DSM17648: A Pilot Study. Probiotics Antimicrob Proteins, 2015, 7(2): 91-100.Holz C, Busjahn A, Mehling H et al. Significant Reduction in Helicobacter pylori Load in Humans with Non-viable Lactobacillus reuteri DSM17648: A Pilot Study. Probiotics Antimicrob Proteins, 2015, 7(2): 91-100.Ford AC, Forman D, Hunt R, et al. Helicobacter pylori eradication for the prevention of gastric neoplasia. Cochrane Database Syst Rev., 2015(7):Cd005583.Ford AC, Forman D, Hunt R, et al. Helicobacter pylori eradication for the prevention of gastric neoplasia. Cochrane Database Syst Rev., 2015(7):Cd005583.Плотникова Е.Ю., Золотухина В.Н., Краснов О.А. Новые возможности адьювантной антихеликобактерной терапии. Лечащий врач, 2015, 3: 76-81.Плотникова Е.Ю., Золотухина В.Н., Краснов О.А. Новые возможности адьювантной антихеликобактерной терапии. Лечащий врач, 2015, 3: 76-81.Бордин Д.С., Войнован И.Н., Хомерики С.Г., Янова О.Б., Ким В.А., Быстровская Е.В., Шишин К. В. Эффективность и безопасность Lactobacillus reuteri DSMZ17648 у инфицированных Helicobacter pylori. Лечащий врач, 2016, 5: 106-112.Бордин Д.С., Войнован И.Н., Хомерики С.Г., Янова О.Б., Ким В.А., Быстровская Е.В., Шишин К. В. Эффективность и безопасность Lactobacillus reuteri DSMZ17648 у инфицированных Helicobacter pylori. Лечащий врач, 2016, 5: 106-112.Успенский Ю.П., Фоминых Ю.А., Иванов С.В., Менакер И.О. Эволюция в эрадикационной терапии НР-ассоциированных заболеваний. Выход за рамки стандартов? РМЖ. Гастроэнтерология, 2016, 17: 1144-1152.Успенский Ю.П., Фоминых Ю.А., Иванов С.В., Менакер И.О. Эволюция в эрадикационной терапии НР-ассоциированных заболеваний. Выход за рамки стандартов? РМЖ. Гастроэнтерология, 2016, 17: 1144-1152.Malfertheiner P, Megraud F, O’Morain CA et al. Management of Helicobacter pylori infection – the Maastricht V/ Florence Consensus Report. Gut, 2016, 0: 1–24.Malfertheiner P, Megraud F, O’Morain CA et al. Management of Helicobacter pylori infection – the Maastricht V/ Florence Consensus Report. Gut, 2016, 0: 1–24.Н.В. Захарова, И.Г. Бакулин, В.И. Симаненков, А.А. Маслыгина. Обзор рекомендаций пятого Маахстрихтского/Флорентийского консенсуса по диагностике и лечению инфекции Helicobacter Pylori. Фарматека. Гастроэнтерология, 2016, 2: 8-27.Н.В. Захарова, И.Г. Бакулин, В.И. Симаненков, А.А. Маслыгина. Обзор рекомендаций пятого Маахстрихтского/Флорентийского консенсуса по диагностике и лечению инфекции Helicobacter Pylori. Фарматека. Гастроэнтерология, 2016, 2: 8-27.

The authors declare that there are no conflicts of interest present.