PDF(Pubmed)
Abstract：
Yu et al\'s study in the World Journal of Gastroenterology (2023) introduced a novel regimen of Vonoprazan-amoxicillin dual therapy combined with Saccharomyces boulardii (S. boulardii) for the rescue therapy against Helicobacter pylori (H. pylori), a pathogen responsible for peptic ulcers and gastric cancer. Vonoprazan is a potassium-competitive acid blocker renowned for its rapid and long-lasting acid suppression, which is minimally affected by mealtime. Compared to proton pump inhibitors, which bind irreversibly to cysteine residues in the H+/K+-ATPase pump, Vonoprazan competes with the K+ ions, prevents the ions from binding to the pump and blocks acid secretion. Concerns with increasing antibiotic resistance, effects on the gut microbiota, patient compliance, and side effects have led to the advent of a dual regimen for H. pylori. Previous studies suggested that S. boulardii plays a role in stabilizing the gut barrier which improves H. pylori eradication rate. With an acceptable safety profile, the dual-adjunct regimen was effective regardless of prior treatment failure and antibiotic resistance profile, thereby strengthening the applicability in clinical settings. Nonetheless, S. boulardii comes in various formulations and dosages, warranting further exploration into the optimal dosage for supplementation in rescue therapy. Additionally, larger, randomized, double-blinded controlled trials are warranted to confirm these promising results.
摘要：
Yu等人在《世界胃肠病学杂志》（2023年）上的研究介绍了沃诺拉赞-阿莫西林双重疗法联合布拉氏酵母菌（S.boulardii）用于针对幽门螺杆菌（H.pylori),引起消化性溃疡和胃癌的病原体。沃诺拉赞是一种钾竞争性酸阻滞剂，以其快速和持久的酸抑制作用而闻名。受进餐时间的影响最小。与质子泵抑制剂相比，不可逆地与H+/K+-ATP酶泵中的半胱氨酸残基结合，Vonoprazan与K+离子竞争，防止离子与泵结合并阻止酸分泌。对抗生素耐药性增加的担忧，对肠道微生物群的影响，患者依从性,和副作用导致幽门螺杆菌双重治疗方案的出现。先前的研究表明，布拉氏链球菌在稳定肠屏障中发挥作用，从而提高幽门螺杆菌的根除率。具有可接受的安全性，无论以前的治疗失败和抗生素耐药性如何，双重辅助方案都是有效的，从而加强在临床环境中的适用性。尽管如此，布拉氏链球菌有各种配方和剂量，有必要进一步探索抢救治疗中补充的最佳剂量。此外,较大,随机化，有必要进行双盲对照试验以证实这些有希望的结果.
