Development of complementary and alternative medicine against antibiotic-resistant Helicobacter pylori infection

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Helicobacter pylori (H.pylori) is now recognized as an important causal agent in gastroduodenal diseases, such as chronic gastritis, peptic ulceration, gastric adenocarcinoma and mucosa-associated lymphoid tissue lymphoma (MALToma). Although the eradication of H.pylori using antibiotics often improves gastroduodenal diseases, resistance to the antibiotics is emerging. In this study, the antimicrobial effects of essential oils and herbal medicines were evaluated in vitro and in vivo. Thirteen essential oils used in this study completely inhibited the growth of H.pylori in vitro at a concentration of 0.1% (vol/vol). Cymbopogon citratus (lemongrass) and Lippia citriodora (lemon verbena) were bactericidal against H.pylori at 0.01% at pH 4.0 and 5.0. Resistance to lemongrass did not develop even after 10 sequential passages, whereas resistance to clarithromycin developed under the same conditions. In in vivo studies, the density of H.pylori in the stomach of mice treated with lemongrass was significantly reduced compared with untreated mice. On the other hand, the antibacterial effects of 18 herbal medicines were also evaluated in vitro and in vivo. Rhei Rhizoma, Artemisiae Capillari Flos and Caryophylli Flos inhibited the growth of H.pylori at a dose of 1mg/ml or more in vitro. Furthermore, the density of H.pylori in the stomach of mice treated with these herbal medicines was significantly reduced. These results demonstrate that the essential oils and herbal medicines are bactericidal against H.pylori without the development of acquired resistance, suggesting that essential oils and herbal medicines may have potential as complementary and alternative medicines for treatment of antibiotic-resistant H.pylori infection.