Lactobacillus rhamnosus attenuates Thai chili extracts induced gut inflammation and dysbiosis despite capsaicin bactericidal effect against the probiotics, a possible toxicity of high dose capsaicin.

Because of a possible impact of capsaicin in the high concentrations on enterocyte injury (cytotoxicity) and bactericidal activity on probiotics, Lactobacillus rhamnosus L34 (L34) and Lactobacillus rhamnosus GG (LGG), the probiotics derived from Thai and Caucasian population, respectively, were tested in the chili-extract administered C57BL/6 mice and in vitro experiments. In comparison with placebo, 2 weeks administration of the extract from Thai chili in mice caused loose feces and induced intestinal permeability defect as indicated by FITC-dextran assay and the reduction in tight junction molecules (occludin and zona occludens-1) using fluorescent staining and gene expression by quantitative real-time polymerase chain reaction (qRT-PCR). Additionally, the chili extracts also induced the translocation of gut pathogen molecules; lipopolysaccharide (LPS) and (1→3)-ß-d-glucan (BG) and fecal dysbiosis (microbiome analysis), including reduced Firmicutes, increased Bacteroides, and enhanced total Gram-negative bacteria in feces. Both L34 and LGG attenuated gut barrier defect (FITC-dextran, the fluorescent staining and gene expression of tight junction molecules) but not improved fecal consistency. Additionally, high concentrations of capsaicin (0.02-2 mM) damage enterocytes (Caco-2 and HT-29) as indicated by cell viability test, supernatant cytokine (IL-8), transepithelial electrical resistance (TEER) and transepithelial FITC-dextran (4.4 kDa) but were attenuated by Lactobacillus condition media (LCM) from both probiotic-strains. The 24 h incubation with 2 mM capsaicin (but not the lower concentrations) reduced the abundance of LGG (but not L34) implying a higher capsaicin tolerance of L34. However, Lactobacillus rhamnosus fecal abundance, using qRT-PCR, of L34 or LGG after 3, 7, and 20 days of the administration in the Thai healthy volunteers demonstrated the similarity between both strains. In conclusion, high dose chili extracts impaired gut permeability and induced gut dysbiosis but were attenuated by probiotics. Despite a better capsaicin tolerance of L34 compared with LGG in vitro, L34 abundance in feces was not different to LGG in the healthy volunteers. More studies on probiotics with a higher intake of chili in human are interesting.

CagA genotype and metronidazole resistant strain of Helicobacter pylori in functional dyspepsia in Thailand.

BACKGROUND AND AIM: Many previous studies indicated relationship between H. pylori infection and functional dyspepsia (FD) but pathogenesis remains unclear. The aim of this study was to determine relationship between cagA genotype and metronidazole resistant strains of H. pylori in Thai FD patients. METHODS: Total of 412 Thai FD patients who underwent gastroscopy at Thammasat University Hospital, Thailand between June 2008 and May 2010 were enrolled. Two antral gastric biopsies were obtained for CLO test, cultures and E-test for metronidazole. Cag A genotype was determined by PCR. FD patients were diagnosed by Rome III criteria and categorized as epigastric pain syndrome (EPS) and postprandial distress syndrome (PDS). RESULTS: 133 FD patients (31%) were infected with H. pylori (56 male, 77 female). There were 37 patients with EPS and 96 patients with PDS. Cag A genotype was performed in 114 patients and CagA 1a was demonstrated in 24.6%. Cag A 1a was relatively higher prevalence in PDS than EPS without statistical significance (26% vs 22%; P > 0.05). E-test for metronidazole was performed in 100 patients (32 EPS and 68 PDS patients) and metronidazole resistant strains were found in 30%. Metronidazole resistant strains were significantly higher in PDS than EPS patients (38.2% vs 12.5%; P = 0.03). In EPS patients, presence of cagA 2a gene was significantly higher in metronidazole resistant than metronidazole sensitive strains (100% vs 74.1%; OR = 4.8, 95% CI = 1.2-26.8, P = 0.01). CONCLUSIONS: PDS was the predominant type of FD in Thailand. Metronidazole resistant strains and cagA 2a gene of H. pylori infection was commonly found in Thai FD patients. In EPS patients, cagA 2a gene might be related to metronidazole resistant strains of H. pylori infection in Thailand.

Ten-day sequential therapy of Helicobacter pylori infection in Thailand.

OBJECTIVES: Antimicrobial resistance has decreased eradication rates of Helicobacter pylori worldwide. The objective of this study was to determine whether a sequential therapy regimen is effective in eradicating H. pylori in adults with nonulcer dyspepsia or peptic ulcer disease in Thailand. METHODS: A total of 115 patients with dyspepsia or peptic ulcer were enrolled in the study. (14)C-urea breath test, upper endoscopy, rapid urease test, bacterial culture, and antibiotic resistance assessment were conducted during the course of the treatment. In all, 115 patients underwent a 10-day sequential regimen, which consisted of lansoprazole (30 mg) plus amoxicillin (1 g) twice a day for 5 days, then lansoprazole (30 mg) with metronidazole (500 mg) twice a day, and clarithromycin (1,000 mg) once a day for another 5 consecutive days. Successful eradication was evaluated by negative urea breath test at least 4 weeks after stopping treatment. RESULTS: Successful eradication was achieved in 106 of 115 patients (95%). All patients completed the treatment, without any dropouts. Mild adverse effects included headache and palpitations. The prevalence rate of clarithromycin-resistant H. pylori was found to be 6.1%. CONCLUSIONS: The 10-day sequential treatment for H. pylori is well tolerated and provides a high eradication rate. This regimen can overcome the emergence of antibiotic resistance and may have a role as a first-line treatment for H. pylori infection in Thailand.