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Beyond Antibiotics: Alternative Strategies Targeting Helicobacter pylori Resistance
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DOI：10.1017/erm.2026.10040.png)
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Abstract
En 中文
The escalating global prevalence of antibiotic-resistant Helicobacter pylori strains has undermined conventional eradication therapies; heightening the burden of associated conditions such as gastritis; peptic ulcers and gastric malignancies. Emerging non-antibiotic alternatives; including natural and synthetic compounds; probiotics and vaccine candidates; offer potential solutions to combat these infections effectively. Natural and synthetic compounds provide promising anti-H. pylori effects; primarily through bacterial membrane disruption; urease inhibition; virulence gene suppression and biofilm prevention. in vitro and in vivo studies support the robust activity of natural agents; while synthetic counterparts demonstrate potent bactericidal and anti-adherence capabilities; though rigorous clinical validation is still required. Probiotic strains enhance eradication rates when combined with antibiotics; reduce treatment-related adverse effects; modulate gut microbiota and attenuate gastric inflammation and carcinogenesis. Vaccine development encompasses whole-cell; subunit and DNA platforms targeting key virulence factors; showing immunogenicity and protective efficacy in preclinical models; yet is limited by variable clinical translation and insufficient large-scale trials. Despite promising advancements; challenges persist; including inconsistent efficacy and a need for more rigorous human studies. Future efforts should emphasize combinatorial therapies; refined delivery systems; and thorough safety evaluations to integrate these strategies into clinical practice; fostering sustainable management of H. pylori in a post-antibiotic era.
Keywords:
Helicobacter pylori
natural compounds
probiotics
synthetic agents
vaccine
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