續教育二幽門螺旋桿菌的檢測方法 Hp 2 (urea breath test, UBT) Hp Hp -13 (C- 13 UBT) Hp 2-13 Hp -13 Hp Hp Hp 95% H2 (proton pump inhibitor lansoprazole omeprazole ) H

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1 益生菌降低幽門螺旋桿菌之療效中山醫學大學附設醫院藥劑科藥師李建瑩中山醫學大學藥理學科副教授施宏哲摘要 (proton pump inhibitor) Hp (1) Hp Hp (2) Hp Th1 IL-10 IL-10 Hp IgG Hp Hp Hp Helicobacter pylori Triple therapy Probiotics 壹前言 1983 Marshall (Helicobacter pylori, Hp) % 80-90% 貳幽門螺旋桿菌一幽門螺旋桿菌的傳染 Hp Hp (gastric metaplasia) 106 THE JOURNAL OF TAIWAN PHARMACY Vol.30 No.1 Mar

2 續教育二幽門螺旋桿菌的檢測方法 Hp 2 (urea breath test, UBT) Hp Hp -13 (C- 13 UBT) Hp 2-13 Hp -13 Hp Hp Hp 95% H2 (proton pump inhibitor lansoprazole omeprazole ) Hp 三幽門螺旋桿菌與免疫反應的關係 3 Hp Hp Hp Hp Th1 Hp 參目前治療幽門螺旋桿菌的方法 Hp Hp Hp Hp (proton pump inhibitor) amoxicillin metronidazole clarithromycin 85% 95% 4 5,6 肆益生菌 (Probiotics) 降低幽門螺旋桿菌的作用 (Lactobacilli) (Bifidus) 30 1 Mar 藥學雜誌第 118 冊 107 繼

3 B Hp Hp Hp 7 Hp L. acidophilus L. johnsonii L. casei subsp. Rhamnosus Hp L. sporogenes Hp 8 (Lactobacillus acidophilus, L. johnsonii, L. gasseri, lactobacillus GG, Bifidobacterium longum, and bioyoghurts) Hp 9 Hp (meta-analysis) Hp Hp Hp 10 Hp Th1 IL-10 IL-10 Hp IgG Hp 11 (monocytes) (macrophages) (dendritic cells) Hp 12 (Basophils) IL-8 IgE (histamine) Hp Lactobacillus acidophilus La5 Bifidobacterium lactis Bb12 AB-yogurt 6 Hp Bifidobacterium lactis Bb12 Hp Lactobacillus acidophilus La5 14 Hp 表一益生菌分泌抗菌物質抑制幽門螺旋桿 15 菌的作用機轉 L. acidophilus 4356 Lactic acid L. acidophilus LB Heat-stable protein L. acidophillus CRL639 autolysins Lactic acid L. casei 393 Lactic acid L. casei strain Shirota Heat-labile substance L. casei subsp. Rhamnosus Lactic acid L. casei strain Shirota Lactic acid L. salivarius WB1040 Lactic acid L. lactis BH5 Bacteriocin W.confusa PL9001 Class II bacteriocin L. johnsonii La1 Heat-stable substance L. reuteri TM 105 Glycolipid-binding proteins B. subtilis 3 Anticoumacin A, B, C 108 THE JOURNAL OF TAIWAN PHARMACY Vol.30 No.1 Mar

4 伍結論 7. 合併使用抑制 Hp 的抗生素與益生菌可增加根除 Hp 的作用在臨床上可運用此種治療方式在三合一療法失敗的病人參考資料 Del Giudice G, Michetti P Inﬂammation, immunity and vaccines for Helicobacter pylori. Helicobacter 2004; 9 Suppl 1: Coelho LG, Silva Jr AE, Coelho MC, et al: Does low dose (13)C-urea breath test maintain a satisfactory accuracy in diagnosing Helicobacter pylori infection? Arq Gastroenterol 2011; 48: Fan XG, Kelleher D, Fan XJ, et al: Helicobacter pylori increases proliferation of gastric epithelial cells. Gut 1996; 38: Labenz J, Leverkus F, Borsch G Omeprazole plus amoxicillin for cure of Helicobacter pylori infection. Factors inﬂuencing the treatment success. Scand J Gastroenterol 1994; 29: Moshkowitz M, Konikoff FM, Peled Y, et al: High Helicobacter pylori numbers are associated with low eradication rate after triple therapy. Gut 1995; 36: Al Somal N, Coley KE, Molan PC, et al: Susceptibility of Helicobacter pylori to the antibacterial activity of manuka honey. J R Soc Med 1994; 87: Michetti P, Dorta G, Wiesel PH, et al: Effect of wheybased culture supernatant of Lactobacillus acidophilus (johnsonii) La1 on Helicobacter pylori infection in humans. Digestion 1999; 60: Lactobacillus sporogenes. Altern Med Rev 2002; 7: Hamilton-Miller JM The role of probiotics in the treatment and prevention of Helicobacter pylori infection. Int J Antimicrob Agents 2003; 22: Montalto M, Curigliano V, Santoro L, et al: Management and treatment of lactose malabsorption. World J Gastroenterol 2006; 12: Zhang L, Su P, Henriksson A, et al: Investigation of the immunomodulatory effects of Lactobacillus casei and Bifidobacterium lactis on Helicobacter pylori infection. Helicobacter 2008; 13: Veckman V, Miettinen M, Matikainen S, et al: Lactobacilli and streptococci induce inflammatory chemokine production in human macrophages that stimulates Th1 cell chemotaxis. J Leukoc Biol 2003; 74: Permin H, Norgaard A, Norn S, et al: IgE-mediated immune response to Helicobacter pylori examined by basophil histamine release in patients with dyspepsia. Inﬂamm Res 2000; 49 Suppl 1: S KY W, Li SN L Effects of ingesting Lactobacillus - and Biﬁdobacterium -containing yogurt in subjects with colonized Helicobacter pylori. Am J Clin Nutr 2004; 80: Lesbros-Pantoflickova D, Corthesy-Theulaz I, Blum AL Helicobacter pylori and probiotics. J Nutr 2007; 137: 812S-818S. 第 30 卷第 1 期 Mar 藥學雜誌第118冊 109 繼續教育益生菌降低幽門螺旋桿菌之療效

5 Inhibitory Activity of Probiotics on Helicobacter Pylori Chien-Ying Lee 1, Hung-Che Shih 2 Chung Shan Medical University Hospital 1 Department of Pharmacology, Chung Shan Medical University 2 Abstract The most commonly used regimen for Helicobacter Pylori (H. pylori) eradication is triple therapy, consisting of a proton pump inhibitor and two antibiotics. Triple therapy has a higher rate of side effects and lower compliance and tend to fail as a result of bacterial resistance and the severity of the bacterial infection. Therefore, safe and simple therapies started to draw attention. Among them, the use of probiotics to reduce H. pylori merits further investigation specially as data on the safety of probiotics suggesting that probiotic therapy is generally considered safe. Several mechanisms by which probiotic bacteria can inhibit H. pylori, including nonimmunologic and immunologic mechanisms. In nonimmunologic mechanism, probiotics may inhibit H. pylori growth by secreting antibacterial substances and inhibiting the attachment of H. pylori to gastrointestinal mucosa. In immunologic mechanisms, when using probiotics for the treatment of clinical conditions associated with a Th1 immune response, it should be noted that probiotics are capable of up-regulating IL-10. It is possible that increased levels of IL-10 may have contributed to the observed the decrease in H. pylori-specific IgG antibodies. This cytokine has previously been shown to down-regulate H. pylori-specific antibody production. Supplementation of anti-h. pylori antibiotic regimens with certain probiotics may also be effective in increasing eradication rates and may be considered helpful for patients with eradication failure. This therapy may be considered helpful for patients with eradication failure. 110 THE JOURNAL OF TAIWAN PHARMACY Vol.30 No.1 Mar

研發與創新驗顯示, 停止攝食乳酸菌後, 在幾週內乳酸菌便會消失, 並不會持續存在於腸道內, 但是短暫的定殖, 還是有刺激腸道免疫系統的效果, 尤其是對服用抗生素或腹瀉感

研發與創新驗顯示, 停止攝食乳酸菌後, 在幾週內乳酸菌便會消失, 並不會持續存在於腸道內, 但是短暫的定殖, 還是有刺激腸道免疫系統的效果, 尤其是對服用抗生素或腹瀉感乳酸菌之保健功效與產品開發撰文 / 陳慶源黃崇真邱雪惠廖啟成益生菌是指具有改善宿主體內內生性微生物相平衡, 並有益於宿主健康的單一或數種微生物一般而言, 益生菌被認定為活菌本身, 但是, 近年發現某類益生菌所衍生之活性

續教育 二 幽門螺旋桿菌的檢測方法 Hp 2 (urea breath test, UBT) Hp Hp -13 (C- 13 UBT) Hp 2-13 Hp -13 Hp Hp Hp 95% H2 (proton pump inhibitor lansoprazole omeprazole ) H

續教育二幽門螺旋桿菌的檢測方法 Hp 2 (urea breath test, UBT) Hp Hp -13 (C- 13 UBT) Hp 2-13 Hp -13 Hp Hp Hp 95% H2 (proton pump inhibitor lansoprazole omeprazole ) H