Probiotics-Containing Yogurts Suppress Helicobacter pylori Load and Modify Immune Response and Intestinal Microbiota in the Helicobacter pylori-Infected Children

Background: The benefits of probiotics to the pediatric Helicobacter pylori infection remain uncertain. We tested whether the H. pylori-infected children have an altered gut microflora, and whether probiotics-containing yogurt can restore such change and improve their H. pylori-related immune cascades. Methods: We prospectively included 38 children with H. pylori infection confirmed by a positive ¹³C-urea breath test (UBT) and 38 age- and sex-matched noninfected controls. All of them have provided the serum and stool samples before and after 4-week ingestion of probiotics-containing yogurt. The serum samples were tested for the TNF-α, IL-10, IL-6, immunoglobulin (Ig) A, G, E, pepsinogens I and II levels. The stool samples were tested for the colony counts of Bifidobacterium spp. and Escherichia coli. The follow-up UBT indirectly assessed the H. pylori loads after yogurt usage. Results: The H. pylori-infected children had lower fecal Bifidobacterium spp. count (p=.009), Bifidobacterium spp./E. coli ratio (p=.04), serum IgA titer (p=.04), and pepsinogens I/II ratio (p<.001) than in controls. In the H. pylori-infected children, 4-week yogurt ingestion reduced the IL-6 level (p<.01) and H. pylori loads (p=.046), but elevated the serum IgA and pepsinogen II levels (p<.001). Moreover, yogurt ingestion can improve the childhood fecal Bifidobacterium spp./E. coli ratio (p=.03). Conclusions: The H. pylori-infected children have a lower Bifidobacterium microflora in gut. The probiotics-containing yogurt can offer benefits to restore Bifidobacterium spp./E. coli ratio in children and suppress the H. pylori load with increment of serum IgA but with reduction in IL-6 in H. pylori-infected children.