Background The Helicobacter pylori eradication rate with standard triple therapy is very low. H. pylori is known to require the nickel-containing metalloenzymes urease and NiFe-hydrogenase to survive at the low pH environment in the stomach. Aim To compare the H. pylori eradication rate of a nickel free-diet associated with standard triple therapy and standard triple therapy alone as the first-line regimen. Methods Fifty-two sex- and age-matched patients at the first diagnosis of H. pylori infection were randomized 1:1 into two different therapeutic schemes: (1) standard LCA (26 patients): lansoprazole 15 mg bid, clarithromycin 500 mg bid and amoxicillin 1,000 mg bid for 7 days with a common diet; (2) standard LCA plus a nickel free-diet (NFD-LCA) (26 patients). Patients followed 30 days of a nickel-free diet plus a week of lansoprazole 15 mg bid, clarithromycin 500 mg bid and amoxicillin 1,000 mg bid starting from day 15 of the diet. Results All patients completed the study. A significantly higher eradication rate was observed in the NFD-LCA group (22/26) versus LCA group (12/26) (p\0.01). Only a few patients (9 of 52) reported the occurrence of mild therapy-related side effects, without any significant differences between the two groups. Conclusions The addition of a nickel-free diet to standard triple therapy significantly increases the H. pylori eradication rate. The reduction of H. pylori urease activity due to the nickel-free diet could expose the bacterium to gastric acid and increase H. pylori’s susceptibility to amoxicillin. Further studies are necessary to confirm this preliminary result.

Campanale, M., Nucera, E., Ojetti, V., Cesario, V., Di Rienzo, T., D'Angelo, G., Pecere, S., Barbaro, F., Gigante, G., De Pasquale, T., Rizzi, A., Cammarota, G., Schiavino, D., Franceschi, F., Gasbarrini, A., Nickel free-diet enhances the Helicobacter pylori eradication rate: a pilot study., <<DIGESTIVE DISEASES AND SCIENCES>>, 2014; (Marzo): 1851-1855 [http://hdl.handle.net/10807/67131]

Nickel free-diet enhances the Helicobacter pylori eradication rate: a pilot study.

Campanale, Mariachiara;Nucera, Eleonora;Ojetti, Veronica;Cesario, Valentina;D'Angelo, Giorgia;Pecere, Silvia;Barbaro, Federico;Gigante, Giovanni;De Pasquale, Tiziana;Rizzi, Angela;Cammarota, Giovanni;Schiavino, Domenico;Franceschi, Francesco;Gasbarrini, Antonio
2014

Abstract

Background The Helicobacter pylori eradication rate with standard triple therapy is very low. H. pylori is known to require the nickel-containing metalloenzymes urease and NiFe-hydrogenase to survive at the low pH environment in the stomach. Aim To compare the H. pylori eradication rate of a nickel free-diet associated with standard triple therapy and standard triple therapy alone as the first-line regimen. Methods Fifty-two sex- and age-matched patients at the first diagnosis of H. pylori infection were randomized 1:1 into two different therapeutic schemes: (1) standard LCA (26 patients): lansoprazole 15 mg bid, clarithromycin 500 mg bid and amoxicillin 1,000 mg bid for 7 days with a common diet; (2) standard LCA plus a nickel free-diet (NFD-LCA) (26 patients). Patients followed 30 days of a nickel-free diet plus a week of lansoprazole 15 mg bid, clarithromycin 500 mg bid and amoxicillin 1,000 mg bid starting from day 15 of the diet. Results All patients completed the study. A significantly higher eradication rate was observed in the NFD-LCA group (22/26) versus LCA group (12/26) (p\0.01). Only a few patients (9 of 52) reported the occurrence of mild therapy-related side effects, without any significant differences between the two groups. Conclusions The addition of a nickel-free diet to standard triple therapy significantly increases the H. pylori eradication rate. The reduction of H. pylori urease activity due to the nickel-free diet could expose the bacterium to gastric acid and increase H. pylori’s susceptibility to amoxicillin. Further studies are necessary to confirm this preliminary result.
Inglese
Campanale, M., Nucera, E., Ojetti, V., Cesario, V., Di Rienzo, T., D'Angelo, G., Pecere, S., Barbaro, F., Gigante, G., De Pasquale, T., Rizzi, A., Cammarota, G., Schiavino, D., Franceschi, F., Gasbarrini, A., Nickel free-diet enhances the Helicobacter pylori eradication rate: a pilot study., <<DIGESTIVE DISEASES AND SCIENCES>>, 2014; (Marzo): 1851-1855 [http://hdl.handle.net/10807/67131]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/67131
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