AUTHOR=Jia Xiaofen , Huang Qiuyue , Lin Miaomiao , Chu Yingming , Shi Zongming , Zhang Xuezhi , Ye Hui 

TITLE=Revealing the novel effect of Jinghua Weikang capsule against the antibiotic resistance of Helicobacter pylori

JOURNAL=Frontiers in Microbiology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2022.962354

DOI=10.3389/fmicb.2022.962354

ISSN=1664-302X

ABSTRACT=<sec><title>Background</title><p><italic>Helicobacter pylori</italic> (<italic>H. pylori</italic>) infects half of the human population globally. Eradication rates with triple or quadruple therapy have decreased owing to the increasing rate of antibiotic resistance. Jinghua Weikang capsule (JWC) is the first and most popular Chinese patent medicine approved by the state for the treatment of gastritis and peptic ulcers caused by <italic>H. pylori</italic> infection in China. Previous studies have found that JWC has a certain bactericidal effect on drug-resistant <italic>H. pylori</italic> and its major component, <italic>Chenopodium ambrosioides</italic> L. inhibits biofilm formation, but the mechanism remains unclear. This study focused on drug-resistant <italic>H. pylori</italic> and explored whether JWC could reverse drug resistance and its related mechanisms.</p></sec><sec><title>Method</title><p>The agar plate dilution method, E-test method, and killing kinetics assay were used to evaluate the bactericidal effect of JWC on antibiotic-resistant <italic>H. pylori</italic> and its effect on antibiotic resistance. Sanger sequencing was used to detect mutations in drug resistance genes. The crystal violet method, scanning electron microscopy, and confocal laser scanning microscopy were used to evaluate the effects of JWC on biofilms. qPCR was performed to evaluate the effect of JWC on the expression of efflux pump-related genes. qPCR and immunofluorescence were used to evaluate the effects of JWC on <italic>H. pylori</italic> adhesion.</p></sec><sec><title>Results</title><p>JWC showed considerable antibacterial activity against drug-resistant <italic>H. pylori</italic> strains, with minimum inhibitory concentration (MIC) values ranging from 64 to 1,024 μg/ml. The MIC of metronidazole (MTZ) against <italic>H. pylori</italic> 26,695–16R decreased from 64 to 6 μg/ml after treatment with 1/2 MIC of JWC. The resistance of <italic>H. pylori</italic> 26,695–16R to MTZ was reversed by JWC, and its effect was better than that of PaβN and CCCP. <italic>H. pylori</italic> 26,695–16R is a moderate biofilm-forming strain, and JWC (16–64 μg/ml) can inhibit the formation of biofilms in <italic>H. pylori</italic> 26,695–16R. JWC reduced the expression of HP0605-HP0607 (<italic>hefABC</italic>), HP0971-HP0969 (<italic>hefDEF</italic>), HP1327-HP1329 (<italic>hefGHI</italic>), and HP1489-HP1487. JWC reduced the adhesion of <italic>H. pylori</italic> to GES-1 cells and the expression of adhesives <italic>NapA</italic>, <italic>SabA</italic>, and <italic>BabA</italic>.</p></sec><sec><title>Conclusion</title><p>The reversal of MTZ resistance by JWC may be achieved through the adhesin/efflux pump-biofilm pathway.</p></sec>