ArticleAlimentary pharmacology & therapeutics2015
Colloidal bismuth subcitrate impedes proton entry into Helicobacter pylori and increases the efficacy of growth-dependent antibiotics.
Article in Alimentary pharmacology & therapeutics, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- The cure rate of 10-day bismuth-containing quadruple therapy for Helicobacter pylori eradication is equivalent to 14-day: a systematic review and meta-analysis.Clinical and experimental medicine · 2023Pooled it
- Amoxicillin or tetracycline in bismuth-containing quadruple therapy as first-line treatment forGut microbes · 2020Trial
- Randomized Clinical Trial: Esomeprazole, Bismuth, Levofloxacin, and Amoxicillin or Cefuroxime as First-Line Eradication Regimens for Helicobacter pylori Infection.Digestive diseases and sciences · 2017Trial
- Controversies in management of Helicobacter pylori infection from a U.S. perspective: population screening and treatment.Minerva gastroenterology · 2025Review
- Insights into Functions of Universal Stress Proteins Encoded by Genomes of Gastric Cancer PathogenPathogens (Basel, Switzerland) · 2025Article
- In Vitro Susceptibility and Synergistic Effect of Bismuth AgainstAntibiotics (Basel, Switzerland) · 2024Article
- Helicobacter pylori infection.Nature reviews. Disease primers · 2023Review
- The Effect of Quadruple Therapy with Polaprezinc or Bismuth on Gut Microbiota afterJournal of clinical medicine · 2022Article
- Facile Synthesis of Zn-Doped BiACS omega · 2021Article
- Cefuroxime, levofloxacin, esomeprazole, and bismuth as first-line therapy for eradicating Helicobacter pylori in patients allergic to penicillin.BMC gastroenterology · 2019Article
- Initial Trials With Susceptibility-Based and Empiric Anti-Frontiers in pharmacology · 2019Article
- Multi-omics and temporal dynamics profiling reveal disruption of central metabolism inChemical science · 2018Article
- Efficacy and Safety of Wei Bi Mei, a Chinese Herb Compound, as an Alternative to Bismuth for Eradication ofEvidence-based complementary and alternative medicine : eCAM · 2018Article
- Eradication of Helicobacter pylori Infection.Current gastroenterology reports · 2016Review
- High-dose dual therapy versus bismuth-containing quadruple therapy for the treatment ofTzu chi medical journalReview
- Action of Colloidal Bismuth Hydroxide Gel and its Commercial Cream on Enteropathogens and Colonizers of the Gastrointestinal Tract.Journal of global infectious diseasesArticle
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundSuccessful eradication of Helicobacter pylori is becoming more difficult, mainly due to emerging antibiotic resistance. Treatment regimens containing bismuth have increased efficacy, but the mechanism is unknown. Helicobacter pylori is a neutralophile adapted to survive the acidic gastric environment via acid acclimation, but demonstrates more robust growth at neutral pH. Many antibiotics used to treat H. pylori rely on bacterial growth.
aimTo investigate the mechanism of increased efficacy of bismuth-containing H. pylori treatment regimens.
methodsRNAseq and qPCR, urease activity in permeabilised and intact bacteria, internal pH and membrane potential were measured with and without colloidal bismuth subcitrate (CBS). Bacterial survival was assessed with CBS and/or ampicillin.
resultsGenes involved with metabolism and growth were upregulated in the presence of CBS at acidic pH. Urease activity of permeabilised H. pylori at pH 7.4 and 4.5 decreased in the presence of CBS, but intact urease activity decreased only at acidic pH. The fall in cytoplasmic pH with external acidification was diminished by CBS. The increase in membrane potential in response to urea addition at acidic medium pH was unaffected by CBS. The impact of CBS and ampicillin on H. pylori survival was greater than either agent alone.
conclusionsBismuth is not acting directly on urease or the urea channel. Colloidal bismuth subcitrate impedes proton entry into the bacteria, leading to a decrease in the expected fall in cytoplasmic pH. With cytoplasmic pH remaining within range for increased metabolic activity of a neutralophile, the efficacy of growth-dependent antibiotics is augmented.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.