Korea red ginseng on Helicobacter pylori-induced halitosis: newer therapeutic strategy and a plausible mechanism.

ABSTRACT

BACKGROUND: Gas chromatographic documentation of volatile sulfur compounds in Helicobacter pylori cultures and the amelioration of halitosis after eradication suggested a causal link between H. pylori infection and halitosis. AIM: We hypothesized that Korea red ginseng can relieve H. pylori-associated halitosis based on their anti-inflammatory and cytoprotective actions in H. pylori-associated gastritis. METHODS: Eighty-eight functional dyspepsia patients presenting with either subjective halitosis or objective halimeter levels >100 ppb were recruited, on whom tests were repeated after 10 weeks of red ginseng administration. The expressions of cystathionine gamma-lyase (CSE), cystathionine beta-synthetase (CBS), IL-6, IL-8 and IL-1beta mRNA were compared in H. pylori-infected or NaHS-treated gastric epithelial cells according to red ginseng treatment. RESULTS: After 10 weeks of red ginseng administration, 38 patients out of 68 H. pylori-positive cases became 'free of halitosis' accompanied with halimeter levels <50 ppb accordant with the subjective resolution of halitosis. Among the remaining 30 patients, 15 cases administered with both eradication regimen and red ginseng supplement showed either higher eradication rates (93.3%) or were found to be completely free of halitosis in comparison to the other 15 patients who were only administered the eradication regimen. Among 20 H. pylori-negative patients, 13 patients became 'free of halitosis' with 10 weeks of red ginseng treatment alone. Red ginseng extracts significantly decreased H. pylori- or NaHS-induced CSE expressions concomitant with attenuated levels of IL-6, IL-8 and IL-1beta mRNA. CONCLUSION: The strategy consisting of Korea red ginseng supplementation after the successful eradication of H. pylori could be an effective way to fight troublesome halitosis.