Antioxidant vitamins may support Helicobacter pylori therapy

Adding vitamin C and vitamin E to standard therapy of H. pylori elimination may increase the rate of eradication, says a new Turkish study.

In the controlled trial, 200 patients infected with Helicobacter pylori were randomly assigned to two groups receiving a standard triple therapy, including lansoprazole (30 mg twice a day) plus amoxicillin (1000 mg twice a day) plus clarithromycin (500 mg twice a day) for 14 days, with or without a combination of vitamin C (500 mg twice a day) plus vitamin E (200 IU twice a day) for 30 days (1). The success of the H. pylori eradication was measured 4–6 weeks after the completion of therapy. The study results showed that eradication rates were significantly higher (up to 37%) in the group which had taken vitamin C and E supplements on top of the standard therapy.

The researchers concluded that supplementing standard triple therapy with high doses of vitamins C and E may increase the eradication rate of H. pylori. They suggested that the antioxidative vitamins C and E may decrease oxidative stress in the gastric mucosa and thus increase the efficacy of antibiotics as part of the triple therapy. Another explanation might be a vitamin-induced improvement in immunity.

Approximately 50% of the world’s population is infected with Helicobacter pylori, which was classified as grade 1 carcinogen by the World Health Organisation in 1994. H. pylori creates a microenvironment beneath the gastric mucosa to protect itself from gastric acid and the host defence systems. It was shown that oxidative stress increases in areas where H. pylori colonizes, which in turn leads to an increase in reactive oxygen species. The imbalance between oxidants and antioxidants caused by H. pylori explains the role of the bacteria in the development of gastric cancer. The currently accepted triple therapy regimens for H. pylori eradication include a proton pump inhibitor plus two antibiotics: amoxicillin and clarithromycin.

1. Sezikli M. et al. Supplementing Vitamins C and E to standard triple therapy for the eradication of Helicobacter pylori. Journal of Clinical Pharmacy and Therapeutics. August 2011