Did you know that Berberine is effective in eliminating Helicobacter pylori?
In this post we talk about a pathology that, according to some studies, has an incidence of more than 50% in our society and in which until recently there were almost no therapeutic options; We are talking about chronic gastritis.

In today’s article we will expose the most relevant characteristics of this condition, the medical case to treat it and an interesting therapy that is an innovation in the eradication of the most identified infectious cause, Helicobacter pylori.

The causes we now know

Let’s make a little history and go back to the year 1983.
At that time it was thought that chronic gastritis was caused by some types of food (especially spicy ones) and this cause influenced according to the personality of the person.
It was then said that a combination of stress, together with an external aggressor such as certain types of food, produced chronic gastritis and most gastric ulcers.

Today we know that chronic gastritis has different causes and as for those of infectious etiology, there are some microorganisms that can cause chronic inflammatory lesions.
The germ most frequently identified in chronic gastritis of the antrum and those associated with duodenal ulcer is Helicobacter pylori.

What they did not know is that their gastritis was possibly due to a bacterium, Helicobacter pylori.

We must not leave aside epigenetics, which tells us about genetic predisposition and the regulation of the expression of certain genes in certain patients to develop this type of disease.

Previously, the unknown Helicobacter pylori

The discovery that most chronic gastritis was caused by an infectious agent gave a lot to talk about.
This discovery was made by two Australian doctors who won the Nobel Prize in Medicine and Physiology in 2005, Robin Warren and Barry Marshall.

The discovery of Helicobacter pylori was a highly controversial topic

In 1979, for the first time, Warren observed the bacterium in inflamed gastric epithelium and later in gastritis associated with peptic ulcer.
Until that moment it was said that it was impossible for a microorganism to grow in an environment as acidic as the stomach.

In 1981, Marshall began a collaboration by obtaining cultures, conducting prospective studies and administering therapeutic regimens with antibiotics and bismuth salts.
The bacterium was first called Campylobacter-like, because of its resemblance to this species.

In 1984, Marshall self-inoculated himself with the agent by ingesting a culture, which caused gastritis.
It was treated and cured with bismuth and metronidazole salts.
Both doctors then presented their findings to the Australian Gastroenterological Association, which rejected the abstract with the preliminary data.

In 1983, the famous journal Lancet published two different correspondences from the authors, who sent the same material separately.
Later, and in collaboration with microbiologists, they classified the new bacterium within the genus Helicobacter and as a pylori species.

Currently, gastritis and peptic ulcer are considered infectious diseases.
In addition, the causal relationship between Helicobacter pylori, adenocarcinoma and gastric lymphoma has been proven, and its relationship with some extradigestive diseases has been suggested.

http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S113001082006001000007&lng=es&nrm=iso

How is it treated?

The classic treatment that is usually used includes the triple antibiotic plan. Three antibiotic agents are combined to prevent resistance by the microorganism.
This plan is carried out with clarithromycin, amoxicillin and metronidazole, or salts of bismuth, metronidazole and tetracycline always associated with a proton pump inhibitor.
The duration of the treatment can vary between 7-14 days.

http://boletin.ciberisciii.es/ciberehd/ciberdetallessubnotica.php?notiID=122&boletinID=22&ciberID=3

In many cases, there is resistance to Helicobacter pylori in antibiotics

On the other hand, despite using the aforementioned combinations, resistance of Helicobacter pylori to nitroimidazoles, macrolides, quinolones and rifampicins, among others, has been detected.
Resistance affects each of the compounds in each group.
In the case of other antibiotics commonly used in eradication therapies, such as amoxicillin and tetracyclines, resistance rates are very low, so the real problem in clinical practice lies mainly in resistance to nitroimidazoles and macrolides.

https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082007000200001

What is Berberine?

Berberine is a type of isoquinoline alkaloid isolated from various plants and is widely used in traditional Chinese medicine.
As an antibiotic, Berberine has been used to treat conditions such as diarrhea for many, many years.

Recently, numerous studies have shown that Berberine has the ability to inhibit Helicobacter pylori in vivo and in vitro. https://doi.org/10.1002/jcb.26681

The efficacy of Berberine combined with standard triple therapy to eradicate Helicobacter pylori is demonstrated

Berberine can also effectively suppress multidrug-resistant strains of H. pylori.
In addition, thanks to the intervention of Berberine, an in vitro model, the minimum inhibitory concentration of amoxicillin and tetracycline for the bacterium was reduced. https://doi.org/ 10.3748/wjg.v21.i14.4225

In addition, Berberine can also suppress the expression of pro-inflammatory genes and regulate the expression of anti-inflammatory genes in mice infected with Helicobacter pylori. The antimicrobial property of Berberine has proven to be of great scientific interest thanks to the decreased efficacy of standard triple therapy. In China, an increasing number of randomized controlled clinical trials confirmed the efficacy of Berberine combined with standard triple therapy for the eradication of Helicobacter pylori.

Adding strategies

As always, the sum of the parts is the best treatment.
A group of researchers in China set out to review an extensive database of randomized studies and concluded that the addition of Berberine to the therapy consisting of two antibiotics plus a proton pump inhibitor significantly improved the eradication rate of Helicobacter pylori.

It was also seen:

• An increased rate of peptic ulcer healing
• An improvement in symptoms
• A reduction in the incidence of side effects compared to applying standard triple therapy alone.

The sum of the parts is the best treatment

It should be remembered that one of the components that have also been used for treatment were bismuth salts, but they brought with them undesirable side effects.
The consequence was a reduction in treatment adherence by patients due to the high frequency of adverse events such as vomiting, abdominal pain, black tongue and diarrhoea.
DOI: 10.3389/fphar.2019.01694

What do we propose?

At Salengei we have developed a product, Active Berberine, from the Barberry plant (Berberis aristata).
It is well known that this substance is also used to deal with situations as diverse as diabetes, hyperlipidemia and high blood pressure.
In fact, this is its most widespread use.

In this article we have tried to emphasize the growing scientific evidence about the use of Berberine associated with other therapeutic weapons to deal with Helicobacter pylori.

It is important to note that Berberine may have inhibitory effects on liver enzymes such as CYP2D6 and CYP3A4, in which case you should consider reducing the dose of these enzymes and always consult your GP.

To conclude

As always at Salengei, we continue to search for and develop the best options for our patients.
These options are intended to put the patient at the center of improvements and try to avoid side effects while providing maximum benefit.

We will meet again in the next article where we will surely develop another interesting topic, whether it comes from our research team or from the doubts that come to us from our readers.

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