plaunotol and Helicobacter-Infections

Topics: 2-Pyridinylmethylsulfinylbenzimidazoles; Amoxicillin; Anti-Ulcer Agents; Clarithromycin; Diterpenes; Drug Resistance, Bacterial; Drug Therapy, Combination; Fatty Alcohols; Helicobacter Infections; Helicobacter pylori; Humans; Lansoprazole; Neutrophil Activation; Omeprazole; Peptic Ulcer; Prognosis

In this study, the effect of different periods of amoxicillin (AMPC) treatment on the eradication rate of Helicobacter pylori in 173 patients with peptic ulcers (gastric ulcer, 109; duodenal ulcer, 64) was investigated. AMPC (1.5 g/day) was administered for 2, 4, or 6 weeks with omeprazole (20mg/day) and plaunotol (240mg/day), a mucoprotective drug, for 8 weeks. The H. pylori eradication rate was 46.7% for 2 weeks' treatment, 83.4% for 4 weeks' treatment, and 100% for 6 weeks' treatment. The eradication rate had a good correlation with the period of AMPC treatment. The healing rates of peptic ulcer at 4 and 8 weeks were 93.3% and 100%, respectively, in the 2-week group, 98.0% and 99.3% in the 4-week group, and 85.7% and 100% in the 6-week group. The recurrence rate of gastric and duodenal ulcers was 3.5% and 0% respectively, in the patients in whom H. pylori was eradicated and 30.0% and 40%, respectively, in the patients in whom H. pylori was not eradicated for 12 months after the H. pylori eradication treatment. Adverse effects of this regimen were observed in 5 (2.9%) of the 173 patients. Diarrhea was observed in 3 patients and eruption in 2. These adverse effects disappeared within a few days after only AMPC was withdrawn. Therefore, these may be caused by AMPC. The eradication rate of H. pylori depends on the period of AMPC treatment. This regiment, AMPC (1.5g/day) + omeprazole (20mg/day) + plaunotol (240mg/day), is safe and well tolerated for eradication of H. pylori.

Topics: Adult; Aged; Aged, 80 and over; Amoxicillin; Anti-Bacterial Agents; Anti-Ulcer Agents; Diterpenes; Drug Administration Schedule; Drug Therapy, Combination; Enzyme Inhibitors; Fatty Alcohols; Female; Helicobacter Infections; Helicobacter pylori; Humans; Male; Middle Aged; Omeprazole; Penicillins; Peptic Ulcer; Retrospective Studies

The aim of the present study was to examine the efficacy and safety of combination therapy with amoxicillin (AMPC), lansoprazole, and plaunotol for the eradication of H. pylori in dialysis patients. The subjects consisted of 15 dialysis patients (10 men and 5 women, mean age of 56 +/- 2.4 years) in whom H. pylori was found in the stomach. H. pylori status was evaluated by histology, culture and rapid urease test with biopsy specimens of the gastric mucosa. The patients were treated with AMPC 500 mg once a day for 3 weeks, lansoprazole 30 mg once a day for 8 weeks and plaunotol 80 mg three times a day for 24 weeks. In addition, the concentrations of serum gastrin and gastric juice ammonia were measured. Fourteen patients completed the treatment schedule, while one discontinued treatment because of nausea and diarrhea. Among the 14 patients, H. pylori was eradicated in 11 without any side effects (eradication rate 78.6%). Concentrations of gastric juice ammonia and serum gastrin were reduced significantly in patients who became H. pylori-negative. The present study indicates that combination therapy with AMPC, lansoprazole and plaunotol is safe and efficient for the eradication of H. pylori in dialysis patients. The results also suggested that elevated concentrations of gastric juice ammonia and serum gastrin in dialysis patients can be attributed, at least in part, to H. pylori infection.

Topics: 2-Pyridinylmethylsulfinylbenzimidazoles; Ammonia; Amoxicillin; Anti-Bacterial Agents; Anti-Ulcer Agents; Diterpenes; Drug Therapy, Combination; Fatty Alcohols; Female; Gastric Juice; Gastrins; Helicobacter Infections; Helicobacter pylori; Humans; Lansoprazole; Male; Middle Aged; Omeprazole; Penicillins; Peritoneal Dialysis, Continuous Ambulatory; Renal Dialysis

Helicobacter pylori eradication therapy combining amoxicillin (AMPC), plaunotol (PL), and a proton pump inhibitor (PPI) was examined as an alternative to triple therapy, which has a high rate of side effects and low patient compliance. Thirty-two H. pylori-positive patients (24 men, 8 women) with duodenal ulcers were examined. The diagnosis of H. pylori infection was made by the urease test on specimens biopsied from two sites in the stomach. Simultaneously, the IgG antibody against H. pylori was measured by the EIA method. The therapeutic regimen was lansoprazole (LPZ) 30 mg q.d. (6 weeks) and AMPC 1,500 mg t.i.d. (2 weeks) plus PL320 mg b.i.d. (6 weeks). The rate of ulcer healing was judged endoscopically after 6 weeks. Cases that become urease-negative after the cessation of the therapy were defined as having achieved clearance, and those negative after 1 month as eradication. Within 6 weeks, 31 of 32 patients had healed ulcers. All patients were H. pylori antibody-positive before therapy. The clearance rate was 71.9% (23/32) and the eradication rate was 45.8% (11/24). Adverse effects were observed only in one case. We conclude that combination therapy with LPZ, AMPC, and PL has a high therapeutic effect on ulcer healing and moderate effectiveness for eradication of H. pylori.

Topics: 2-Pyridinylmethylsulfinylbenzimidazoles; Adult; Aged; Amoxicillin; Anti-Ulcer Agents; Diterpenes; Drug Therapy, Combination; Duodenal Ulcer; Fatty Alcohols; Female; Helicobacter Infections; Helicobacter pylori; Humans; Lansoprazole; Male; Middle Aged; Omeprazole; Penicillins; Proton Pump Inhibitors

We investigated the eradication and recurrence rate of Helicobacter pylori-infected gastric ulcer patients by combination therapies. Eighty-six H. pylori-positive gastric ulcer patients were assigned randomly to one of seven groups: I, omeprazole 20 mg (n = 9); II, lansoprazole (LPZ) 30 mg (n = 16); III, LPZ 30 mg plus plaunotol 480 mg (n = 13); IV, LPZ 30 mg plus ecabet sodium 2 g (n = 11); V, LPZ 30 mg plus clarithromycin 600 mg (the first 2 weeks; n = 11); VI, LPZ 30 mg plus plaunotol 480 mg plus clarithromycin 600 mg (the first 2 weeks; n = 13); and VII, LPZ 30 mg plus ecabet sodium 2 g plus amoxicillin 1,500 mg (the first 2 weeks; n = 13). All therapy was for 8 weeks except where otherwise noted. H. pylori eradication rates as diagnosed by culture, histology, urease test, and [13C]urea breath test 4 weeks after stopping therapy were 0, 0, 8, 45, 6, 46, and 62%, respectively, in groups I-VII. No patient achieving H. pylori eradication suffered recurrence. The combination therapies with proton pump inhibitors in addition to antibiotics and antiulcer agents are safe and effective in H. pylori eradication.

Topics: 2-Pyridinylmethylsulfinylbenzimidazoles; Abietanes; Adult; Amoxicillin; Anti-Bacterial Agents; Anti-Ulcer Agents; Clarithromycin; Diterpenes; Fatty Alcohols; Female; Helicobacter Infections; Helicobacter pylori; Humans; Lansoprazole; Male; Middle Aged; Omeprazole; Penicillins; Proton Pump Inhibitors; Recurrence; Stomach Ulcer

To investigate the effect of plaunotol in combination with proton-pump inhibitors on Helicobacter pylori eradication in patients with gastric ulcer.. We studied 65 H. pylori-positive gastric ulcer patients. They were randomly assigned to five treatment groups: omeprazole (group I, n = 8), lansoprazole (group II, n = 13), lansoprazole+plaunotol (group III, n = 12), lansoprazole+clarithromycin (group IV, n = 16) and lansoprazole+plaunotol+clarithromycin (group V, n = 16). Ulcer status was diagnosed by endoscopy and H. pylori status by culture, histology, a urease test and a urea breath test at baseline, and after 8 and 12 weeks. The clearance and eradication rates were compared in each group.. The healing rates in groups I-V were 100, 92, 100, 100 and 100%, respectively; clearance rates were 0, 23, 42, 50 and 75%, respectively; and eradication rates were 0, 0, 8, 38 and 69%, respectively.. Combination therapy with plaunotol is efficacious for the eradication of H. pylori in gastric ulcer patients.

Topics: Anti-Bacterial Agents; Anti-Ulcer Agents; Biopsy; Clarithromycin; Colony Count, Microbial; Diterpenes; Drug Therapy, Combination; Fatty Alcohols; Gastric Mucosa; Gastroscopy; Helicobacter Infections; Helicobacter pylori; Humans; Stomach Ulcer

The goals of this study were to assess the effectiveness of a new triple therapy consisting of amoxicillin and metronidazole with plaunotol in the eradication of Helicobacter pylori infection in humans, and to determine whether this treatment regimen reduces the rate of recurrence of gastric ulcer in patients infected with H. pylori, without instituting maintenance therapy with H2-receptor antagonists.. Thirty patients with active gastric ulcer who were infected with H. pylori were first treated with omeprazole until scarring occurred. Patients then received plaunotol for 4 wk, with amoxicillin and metronidazole for 7 days.. This triple therapy resulted in the safe eradication of H. pylori in 26 (86.7%) of 30 patients, with no recurrence of ulcer seen during a 12-month follow-up period in patients who tested negative for the presence of H. pylori. In addition, histological inflammatory changes improved in these patients. Of the four patients with persistent H. pylori infection, in three (75%), ulcers recurred.. This new triple therapy was very effective in eradicating H. pylori in infected patients and in reducing the rate of recurrence of gastric ulcer in these patients.

Topics: Amoxicillin; Anti-Ulcer Agents; Diterpenes; Drug Therapy, Combination; Fatty Alcohols; Female; Gastric Mucosa; Helicobacter Infections; Helicobacter pylori; Humans; Male; Metronidazole; Middle Aged; Omeprazole; Recurrence; Stomach Ulcer

Recently, there has been a decrease in the eradication rate of Helicobacter pylori due to the increase in antibiotic resistance of this bacterium. Plaunotol, a cytoprotective anti-ulcer agent, exhibits antibacterial activity against H. pylori. The purpose of the present study was to investigate the effect of plaunotol in combination with clarithromycin against clarithromycin-resistant H. pylori clinical isolates.. In the chequerboard titration method, the combination of plaunotol and clarithromycin showed a synergistic effect against 67% (10/15) clarithromycin-resistant strains and an additive effect against the other strains. No indifferent and antagonistic effects were observed against any of the strains tested. In a gastritis model of Mongolian gerbils infected with clarithromycin-resistant H. pylori, the plaunotol (40 mg/kg) and clarithromycin (66.6 mg/kg) combination exhibited synergistic effects; however, neither plaunotol nor clarithromycin alone showed bactericidal effects.. These results suggest that plaunotol may play a useful role in combination with anti-H. pylori drugs in the treatment of diseases associated with clarithromycin-resistant H. pylori.

Topics: Animals; Anti-Bacterial Agents; Clarithromycin; Diterpenes; Drug Resistance, Bacterial; Drug Therapy, Combination; Fatty Alcohols; Genetic Variation; Gerbillinae; Helicobacter Infections; Helicobacter pylori; Male; Microbial Sensitivity Tests; Specific Pathogen-Free Organisms

Plaunotol, a cytoprotective anti-ulcer agent, has antibacterial activity against Helicobacter pylori. The purpose of the present study was to investigate the effect of plaunotol when combined with clarithromycin or amoxicillin against H. pylori. When combined with clarithromycin, plaunotol showed synergic activity against 11 of 14 strains, and additive activity against the other three strains, by chequerboard titration. When combined with amoxicillin, plaunotol showed additive activity against 10 of 14 strains. No antagonistic effects were seen against any of the strains tested. The interactions between plaunotol and either clarithromycin or amoxicillin were determined by time-kill assay against the Sydney Strain (strain SS1) of H. pylori. The combination of plaunotol with clarithromycin showed synergic activity and with amoxicillin showed additive activity. In a C57BL/6 mouse gastritis model infected with H. pylori SS1, the plaunotol-clarithromycin and plaunotol-amoxicillin combinations both exhibited synergic effects, which allowed the effective dose of clarithromycin to be reduced when co-administered with plaunotol. These results suggest that plaunotol may have a useful role in combination with anti-H. pylori drugs in the treatment of H. pylori-associated diseases.

Topics: Amoxicillin; Animals; Anti-Bacterial Agents; Clarithromycin; Colony Count, Microbial; Disease Models, Animal; Diterpenes; Drug Synergism; Drug Therapy, Combination; Fatty Alcohols; Helicobacter Infections; Helicobacter pylori; Male; Mice; Mice, Inbred C57BL; Microbial Sensitivity Tests; Stomach

It has been suggested that gastric mucosal injury induced by Helicobacter pylori infection is mediated by interleukin-8 (IL-8).. We studied the effect of plaunotol, a drug extracted from the Plau-noi tree of Thailand, and reported it to be effective in the treatment of ulcers, of IL-8 secretion induced by H. pylori and of the inhibitory adhesion activity of the bacterium to gastric epithelial cells. Moreover, the therapeutic effect of plaunotol on H. pylori infection was assessed by using the gnotobiotic murine model.. Plaunotol inhibited the growth of H. pylori (1.5 x 10(4) c.f.u./mL) at high doses (24-48 microg/mL), but not at low doses (3-6 microg/mL). Interleukin-8 secretion induced by H. pylori was inhibited by coculture with plaunotol in a dose-dependent manner. The adhesion of H. pylori to MKN45 cells was also suppressed by coculture with plaunotol in a dose-dependent manner. An in vivo study showed that plaunotol improved histological gastritis and decreased the H. pylori antibody titre.. These findings suggest that plaunotol has a therapeutic effect on gastritis induced by H. pylori.

Topics: Administration, Oral; Animals; Anti-Ulcer Agents; Antibodies, Bacterial; Bacterial Adhesion; Diterpenes; Dose-Response Relationship, Drug; Epithelial Cells; Fatty Alcohols; Gastric Mucosa; Helicobacter Infections; Helicobacter pylori; Humans; Immunoassay; Interleukin-8; Male; Mice; Mice, Inbred BALB C; Rabbits; Stomach Neoplasms; Stomach Ulcer; Tumor Cells, Cultured

The efficacy and safety of combination therapy with amoxicillin, lansoprazole, and plaunotol for the eradication of Helicobacter pylori in patients on dialysis were evaluated. The study subjects comprised 15 dialysis patients in whom H pylori had been found in the gastric mucosa. The patients were given 500 mg amoxicillin once a day for 3 weeks, 30 mg lansoprazole once a day for 8 weeks, and 80 mg plaunotol three times a day for 24 weeks. Endoscopy was performed on entry and at 4 and 24 weeks after cessation of amoxicillin. The concentrations of serum gastrin and gastric juice ammonia also were measured. Fourteen patients completed the treatment protocol, one having dropped out because of nausea and diarrhea. H pylori was eradicated in 11 of the 14 patients 4 weeks after the end of amoxicillin therapy (eradication rate, 78.6%). All but one patient was free of H pylori 24 weeks after the amoxicillin was discontinued. Patients who became negative for H pylori had significantly decreased serum gastrin and gastric juice ammonia concentrations. Our findings indicate that a combination of amoxicillin, lansoprazole, and plaunotol can be used to eradicate H pylori in patients on dialysis.

Topics: 2-Pyridinylmethylsulfinylbenzimidazoles; Amoxicillin; Anti-Bacterial Agents; Anti-Ulcer Agents; Combined Modality Therapy; Diterpenes; Drug Evaluation; Drug Therapy, Combination; Fatty Alcohols; Female; Helicobacter Infections; Helicobacter pylori; Humans; Kidney Failure, Chronic; Lansoprazole; Male; Middle Aged; Omeprazole; Penicillins; Peptic Ulcer; Renal Dialysis; Time Factors

Recently, some antiulcer agents have been reported to have antibacterial activity against Helicobacter pylori, which is highly associated with gastritis and peptic ulcers. In-vitro and in-vivo activity of plaunotol, a cytoprotective antiulcer agent, against H. pylori was investigated. Antibacterial activity of plaunotol against a standard strain (NCTC 11637) and 14 clinical isolates was compared with those of other cytoprotective antiulcer agents: benexate, sofalcone, teprenone, cetraxate, and gefarnate, by an agar dilution method. The MIC50 and MIC90 of plaunotol against 15 strains were 6.25 and 12.5 mg/L, respectively, making it the most potent of the cytoprotective antiulcer agents. The bactericidal effect of plaunotol was investigated using an in-vitro killing assay. Plaunotol at concentrations of more than 6 mg/L induced a rapid reduction of culture turbidity, with an extensive loss of viability, within 30 min. Observation by scanning electron microscopy revealed that plaunotol caused autolysis and treated cells were deformed. In-vivo activity of plaunotol against H. pylori was examined in a nude mouse gastritis model. Plaunotol significantly decreased the number of H. pylori in the stomach of nude mice. In addition, the antiulcer agent enhanced the antibacterial activity of amoxycillin or clarithromycin in the infection model.

Topics: Amoxicillin; Animals; Anti-Bacterial Agents; Anti-Ulcer Agents; Clarithromycin; Diterpenes; Dose-Response Relationship, Drug; Drug Therapy, Combination; Fatty Alcohols; Helicobacter Infections; Helicobacter pylori; Mice; Mice, Inbred BALB C; Microbial Sensitivity Tests; Microscopy, Electron, Scanning

A relationship between allergic diseases and Helicobacter pylori infection has recently been noted. We report a case of atopic dermatitis and H. pylori infection in a 14-year-old girl. She had had widespread diffuse skin erythema with erosions and pigmentation since the age of 3 years. Endoscopically, there was chronic antral gastritis with H. pylori infection and histological eosinophilic infiltration. A high titer of H. pylori-specific IgG was present in serum. She was treated with a proton pump inhibitor (lansoprazole 60 mg), an antibiotic (clarithromycin 800 mg), and plaunotol (a mucosal protective agent, 480 mg) for 2 weeks to eliminate the infection. After 10 days of treatment, erythema and itching were more widespread and vesicle formation was seen on the foot. Generalized skin lesions abated a few days later. After eradication of the bacterium by the treatment, eosinophils decreased from 38.8% to 19.0%, and the clinical signs of atopic dermatitis almost disappeared. Serum gastrin level and the pepsinogen I/II ratio were normalized and histological findings of gastric mucosa showed improvement. H. pylori-specific IgE antibody, analyzed by the Western blot method, gradually decreased with the eradication treatment.

Topics: 2-Pyridinylmethylsulfinylbenzimidazoles; Adolescent; Anti-Bacterial Agents; Anti-Ulcer Agents; Blotting, Western; Clarithromycin; Dermatitis, Atopic; Diterpenes; Drug Therapy, Combination; Fatty Alcohols; Female; Gastric Mucosa; Gastritis; Helicobacter Infections; Helicobacter pylori; Humans; Lansoprazole; Omeprazole; Proton Pump Inhibitors

To evaluate the efficacy of a new triple therapy (amoxycillin, metronidazole, plaunotol) in eradicating Helicobacter pylori in a nude mouse model and in humans.. In an animal study we used 215 nude mice infected with H. pylori to assess the ability of single, dual and triple therapy to eradicate H. pylori from the mouse stomach. The number of H. pylori in the mouse stomach and extent of the gastritis was assessed from 1 to 4 weeks after treatment. In a human study, we enrolled 78 H. pylori-positive patients with recurrent peptic ulcer diseases, 29 of whom were given triple therapy (amoxycillin and metronidazole for 1 week and plaunotol for 4 weeks). Patients in the control group (n = 49) were given a histamine H2-receptor antagonist. All patients were assessed 5 and 11 months after completion of therapy.. In the mouse model, both the number of H. pylori and the gastritis score were significantly lower in the triple therapy group than in any other treatment group assessed 1-4 weeks after completion of therapy. In the human study, the triple therapy eradicated H. pylori from the stomachs of 25 out of 29 patients (86%), compared to the control group in which none of the 49 patients were free of H. pylori in the stomach 11 months after completion of therapy. There were no reported side effects with this triple therapy. None of the H. pylori-eradicated patients showed a recurrence of peptic ulcer disease; three of the four patients whose H. pylori was not eradicated by triple therapy showed a peptic ulcer recurrence within the study period, whereas 16 out of 49 patients in the control group had a peptic ulcer recurrence.. This new triple therapy was effective in the eradication H. pylori, had very few side effects and greatly reduced the rate of recurrent peptic ulcers.

Topics: Amoxicillin; Animals; Anti-Ulcer Agents; Antitrichomonal Agents; Bismuth; Colony Count, Microbial; Contraindications; Disease Models, Animal; Diterpenes; Drug Therapy, Combination; Fatty Alcohols; Gastritis; Helicobacter Infections; Helicobacter pylori; Histamine H2 Antagonists; Humans; Male; Metronidazole; Mice; Mice, Inbred BALB C; Mice, Nude; Penicillins; Peptic Ulcer; Recurrence; Severity of Illness Index; Treatment Outcome

developing a new therapy for eradication of H. pylori by using the nude mouse model.. By quantifying the number of colonies of Helicobacter pylori and the score of H. pylori-associated gastritis from the gastric tissue following different drug regimens in inoculated nude mice, we evaluated the effectiveness of each regimen, including a new drug, plaunotol. Drugs were administered daily for a 1-wk period, beginning 4 wk after inoculation.. In the examination after therapy, the number of colonies of H. pylori and the score of gastritis in the triple-therapy group were significantly lower than in any of the singly- and dual-drug groups or control group from 5 wk to the end of the study after inoculation. Inflammation of the stomach was less apparent in the treatment groups than in the control group.. With the nude mouse model, we quantitatively demonstrated that the new triple therapy is the most effective therapy for eradication of H. pylori.

Topics: Amoxicillin; Animals; Anti-Ulcer Agents; Diterpenes; Drug Evaluation, Preclinical; Drug Therapy, Combination; Fatty Alcohols; Gastric Mucosa; Gastritis; Helicobacter Infections; Helicobacter pylori; Male; Metronidazole; Mice; Mice, Inbred BALB C; Mice, Nude