Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Complementary Medicine and Therapies
Published in: BMC Complementary Medicine and Therapies 1/2015

Open Access 01-12-2015 | Research article

In vitro effect of bergamot (Citrus bergamia) juice against cagA-positive and-negative clinical isolates of Helicobacter pylori

Authors: Angela Filocamo, Carlo Bisignano, Nadia Ferlazzo, Santa Cirmi, Giuseppina Mandalari, Michele Navarra

Published in: BMC Complementary Medicine and Therapies | Issue 1/2015

Login to get access

Abstract

Background

Helicobacter pylori infection has been associated with chronic gastritis, peptic ulcer and gastric carcinoma as over half of the world's population is colonized with this gram-negative bacterium. Due to the increasing antibiotic resistance, its eradication rates fails in a great portion of patients. A number of studies showed that molecules largely distributed in commonly consumed fruits and vegetables may have antimicrobial activity. The aim of the present study was to investigate the effect of bergamot juice (BJ) against Helicobacter pylori in vitro. The potential therapeutic combination between BJ and the antibiotics amoxicillin (AMX), clarithromycin (CLA) and metronidazole (MTZ) has also been evaluated.

Methods

The minimum inhibitory concentration (MIC) of BJ, AMX, CLA and MTZ against 2 ATCC and 32 clinical isolates of H. pylori was assayed according to CLSI. The checkerboard method was used to determine the efficacy of the association BJ with the three reference antibiotics.
Killing curves were performed on the two cagA-positive ATCC strains of H. pylori (ATCC 43504 and ATCC 49503), on the clinical isolate cagA-positive HP6 strain of H. pylori and on the clinical isolate cagA-negative HP61 strain of H. pylori.

Results

BJ (2.5 %, v/v) inhibited the growth of 50 % of the H. pylori clinical isolates, whereas 5 % (v/v) inhibited 90 %. AMX was the most effective antibiotic against the reference strains and the clinical isolates, followed by CLA and MTZ. In the combination assays, synergism was observed between BJ and AMX and between BJ and MTZ against both the reference strains and the clinical isolates. Indifference was observed between BJ and CLA.

Conclusions

BJ was effective in vitro against H. pylori and the genotype status of the clinical strains may have an impact on its susceptibility. The synergistic combination of BJ and antibiotics could be used to prevent or treat resistance.
Literature
1.
Covacci A, Telford JL, Del Giudice G, Parsonnet J, Rappuoli R. Helicobacter pylori virulence and genetic geography. Science. 1999;284(5418):1328–33.CrossRefPubMed
2.
Momtaz H, Souod N, Dabiri H. Comparison of the virulence factors of Helicobacter pylori isolated in stomach and saliva in Iran. Am J Med Sci. 2010;340(5):345–9.CrossRefPubMed
3.
Hunt RH, Xiao SD, Megraud F, Leon-Barua R, Bazzoli F, van der Merwe S, et al. Helicobacter pylori in developing countries. World Gastroenterology Organisation Global Guideline. J Gastrointestin Liver Dis. 2011;20(3):299–304.
4.
Atherton JC, Cao P, Peek Jr RM, Tummuru MK, Blaser MJ, Cover TL. Mosaicism in vacuolating cytotoxin alleles of Helicobacter pylori. Association of specific vacA types with cytotoxin production and peptic ulceration. J Biol Chem. 1995;270(30):17771–7.CrossRefPubMed
5.
Akopyants NS, Clifton SW, Kersulyte D, Crabtree JE, Youree BE, Reece CA, et al. Analyses of the cag pathogenicity island of Helicobacter pylori. Mol Microbiol. 1998;28(1):37–53.
6.
Peek Jr RM, Blaser MJ, Mays DJ, Forsyth MH, Cover TL, Song SY, et al. Helicobacter pylori strain-specific genotypes and modulation of the gastric epithelial cell cycle. Cancer Res. 1999;59(24):6124–31.
7.
Rudi J, Kolb C, Maiwald M, Kuck D, Sieg A, Galle PR, et al. Diversity of Helicobacter pylori vacA and cagA genes and relationship to VacA and CagA protein expression, cytotoxin production, and associated diseases. J Clin Microbiol. 1998;36(4):944–8.
8.
9.
Graham DY. Therapy of Helicobacter pylori: current status and issues. Gastroenterology. 2000;118(2 Suppl 1):S2–8.CrossRefPubMed
10.
Gerrits MM, van Vliet AH, Kuipers EJ, Kusters JG. Helicobacter pylori and antimicrobial resistance: molecular mechanisms and clinical implications. Lancet Infect Dis. 2006;6(11):699–709.CrossRefPubMed
11.
Fukai T, Marumo A, Kaitou K, Kanda T, Terada S, Nomura T. Anti-Helicobacter pylori flavonoids from licorice extract. Life Sci. 2002;71(12):1449–63.CrossRefPubMed
12.
Shin JE, Kim JM, Bae EA, Hyun YJ, Kim DH. In vitro inhibitory effect of flavonoids on growth, infection and vacuolation of Helicobacter pylori. Planta Med. 2005;71(3):197–201.CrossRefPubMed
13.
Nostro A, Cellini L, Di Bartolomeo S, Di Campli E, Grande R, Cannatelli MA, et al. Antibacterial effect of plant extracts against Helicobacter pylori. Phytother Res. 2005;19(3):198–202.
14.
Bisignano C, Filocamo A, La Camera E, Zummo S, Fera MT, Mandalari G. Antibacterial activities of almond skins on cagA-positive and-negative clinical isolates of Helicobacter pylori. BMC Microbiol. 2013;13:103.CrossRefPubMedPubMedCentral
15.
16.
Delle Monache S, Sanita P, Trapasso E, Ursino MR, Dugo P, Russo M, et al. Mechanisms Underlying the Anti-Tumoral Effects of Citrus bergamia Juice. PLoS One. 2013;8(4):e61484.
17.
Navarra M, Ursino MR, Ferlazzo N, Russo M, Schumacher U, Valentiner U. Effect of Citrus bergamia juice on human neuroblastoma cells in vitro and in metastatic xenograft models. Fitoterapia. 2014;95:83–92.CrossRefPubMed
18.
Visalli G, Ferlazzo N, Cirmi S, Campiglia P, Gangemi S, Di Pietro A, et al. Bergamot Juice Extract Inhibits Proliferation by Inducing Apoptosis in Human Colon Cancer Cells. Anti-Cancer Agent Me. 2014;14(10):1402–13.
19.
Ferlazzo N, Visalli G, Smeriglio A, Cirmi S, Lombardo GE, Campiglia P, et al. Flavonoid fraction of orange and bergamot juice protect human lung epithelial cells from hydrogen peroxide-induced oxidative stress. Evid-Based Compl Altern Med. 2015;1: 14.
20.
Risitano R, Curro M, Cirmi S, Ferlazzo N, Campiglia P, Caccamo D, et al. Flavonoid Fraction of Bergamot Juice Reduces LPS-Induced Inflammatory Response through SIRT1-Mediated NF-kappa B Inhibition in THP-1 Monocytes. PLoS One. 2014;9(9):e107431.0.
21.
Impellizzeri D, Bruschetta G, Di Paola R, Ahmad A, Campolo M, Cuzzocrea S, et al. The anti-inflammatory and antioxidant effects of bergamot juice extract (BJe) in an experimental model of inflammatory bowel disease. Clin Nutr. 2014. doi:10.​1016/​j.​clnu.​2014.​11.​012.
22.
Marino A, Paterniti I, Cordaro M, Morabito R, Campolo M, Navarra M, et al. Role of natural antioxidants and potential use of bergamot in treating rheumatoid arthritis. Pharma Nutrition. 2015;3(2):53–9.
23.
Mollace V, Sacco I, Janda E, Malara C, Ventrice D, Colica C, et al. Hypolipemic and hypoglycaemic activity of bergamot polyphenols: From animal models to human studies. Fitoterapia. 2011;82(3):309–16.
24.
Miceli N, Mondello MR, Monforte MT, Sdrafkakis V, Dugo P, Crupi ML, et al. Hypolipidemic effects of Citrus bergamia Risso et Poieteau juice in rats fed a hypercholesterolemic diet. J Agric Food Chem. 2007;55(26):10671–7.
25.
Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; twentieth informational supplement. M100-S22. Wayne: PA: CLSI; 2012.
26.
White RL, Burgess DS, Manduru M, Bosso JA. Comparison of three different in vitro methods of detecting synergy: time-kill, checkerboard, and E test. Antimicrob Agents Chemother. 1996;40(8):1914–8.
27.
Filocamo A, Bisignano C, D'Arrigo M, Ginestra G, Mandalari G, Galati EM. Norfloxacin and ursolic acid: in vitro association and postantibiotic effect against Staphylococcus aureus. Lett Appl Microbiol. 2011;53(2):193–7.
28.
Trombetta D, Castelli F, Sarpietro MG, Venuti V, Cristani M, Daniele C, et al. Mechanisms of antibacterial action of three monoterpenes. Antimicrob Agents Chemother. 2005;49(6):2474–8.
29.
Xiao ZP, Shi DH, Li HQ, Zhang LN, Xu C, Zhu HL. Polyphenols based on isoflavones as inhibitors of Helicobacter pylori urease.Bioorgan Med Chem. 2007;15(11):3703–10.
30.
Ansari FL, Umbreen S, Hussain L, Makhmoor T, Nawaz SA, Lodhi MA, et al. Syntheses and biological activities of chalcone and 1,5-benzothiazepine derivatives: promising new free-radical scavengers, and esterase, urease, and alpha-glucosidase inhibitors. Chem Biodivers. 2005;2(4):487–96.
31.
Tombola F, Campello S, De Luca L, Ruggiero P, Del Giudice G, Papini E, et al. Plant polyphenols inhibit VacA, a toxin secreted by the gastric pathogen Helicobacter pylori. FEBS Lett. 2003;543(1–3):184–9.32.
32.
Mandalari G, Bennett RN, Bisignano G, Trombetta D, Saija A, Faulds CB, et al. Antimicrobial activity of flavonoids extracted from bergamot (Citrus bergamia Risso) peel, a byproduct of the essential oil industry. J Appl Microbiol. 2007;103(6):2056–64.
Metadata
Title
In vitro effect of bergamot (Citrus bergamia) juice against cagA-positive and-negative clinical isolates of Helicobacter pylori
Authors
Angela Filocamo
Carlo Bisignano
Nadia Ferlazzo
Santa Cirmi
Giuseppina Mandalari
Michele Navarra
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Complementary Medicine and Therapies / Issue 1/2015
Electronic ISSN: 2662-7671
DOI
https://doi.org/10.1186/s12906-015-0769-2

Other articles of this Issue 1/2015

BMC Complementary Medicine and Therapies 1/2015 Go to the issue

Research article

Protective effect of Daming capsule against chronic cerebral ischemia

Research article

Supportive but “worried”: perceptions of naturopaths, homeopaths and Chinese medicine practitioners through a regulatory transition in Ontario, Canada

Research article

Study on health hazards through medicines purchased on the Internet: a cross-sectional investigation of the quality of anti-obesity medicines containing crude drugs as active ingredients

Research article

Effect of the aqueous extract of the aerial parts of Monsonia angustifolia E. Mey. Ex A. Rich., on the sexual behaviour of male Wistar rats

Research article

Gastroprotective and ulcer healing effects of piptadeniastrum Africanum on experimentally induced gastric ulcers in rats

Research article

Green tea extract and its major constituent epigallocatechin-3-gallate inhibit growth and halitosis-related properties of Solobacterium moorei