{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T11:19:25Z","timestamp":1784287165185,"version":"3.55.0"},"reference-count":67,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T00:00:00Z","timestamp":1720742400000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Antimicrobial\u2010resistant\n                      <jats:italic>Helicobacter pylori<\/jats:italic>\n                      (\n                      <jats:italic>H. pylori<\/jats:italic>\n                      ) poses a significant public health concern, especially given the limited therapeutic options for azithromycin\u2010resistant strains. Hence, there is a necessity for new studies to reconsider the use of azithromycin, which has diminished in effectiveness against numerous strains. Thus, we aimed to augment azithromycin's anti\u2010\n                      <jats:italic>Helicobacter<\/jats:italic>\n                      properties by combining it with curcumin in different formulations, including curcumin in clove oil, curcumin nano\u2010gold emulsion, and curcumin nanoemulsion.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The antimicrobial activities of the investigated compounds, both individually and in combination with other anti\u2010\n                      <jats:italic>Helicobacter<\/jats:italic>\n                      drugs, were evaluated. Their antibiofilm and anti\u2010virulence properties were assessed using both phenotypic and genotypic methods, alongside molecular docking studies. Our findings were further validated through mouse protection assays and histopathological analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We observed high anti\u2010\n                      <jats:italic>Helicobacter<\/jats:italic>\n                      activities of curcumin, especially curcumin nanoemulsion. A synergistic effect was detected between curcumin nanoemulsion and azithromycin with fraction inhibitory concentration index (FICI) values &lt;0.5. The curcumin nanoemulsion was the most active anti\u2010biofilm and anti\u2010virulence compound among the examined substances. The biofilm\u2010correlated virulence genes (\n                      <jats:italic>babA<\/jats:italic>\n                      and\n                      <jats:italic>hopQ<\/jats:italic>\n                      ) and\n                      <jats:italic>ureA<\/jats:italic>\n                      genes were downregulated (fold change &lt;1) post\u2010treatment with curcumin nanoemulsion. On the protein level, the anti\u2010virulence activities of curcumin nanoemulsion were documented based on molecular docking studies. These findings aligned with histopathological scoring of challenge mice, affirming the superior efficacy of curcumin nanoemulsion\/azithromycin combination.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The anti\u2010\n                      <jats:italic>Helicobacter<\/jats:italic>\n                      activities of all curcumin physical forms pose significant challenges due to their higher \u00a0minimum inhibitory concentration (MIC) values exceeding the maximum permissible level. However, using curcumin nanoemulsion at sub\u2010MIC levels could enhance the anti\u2010\n                      <jats:italic>Helicobacter<\/jats:italic>\n                      activity of azithromycin and exhibit anti\u2010virulence properties, thereby improving patient outcomes and addressing resistant pathogens. Therefore, more extensive studies are necessary to assess the safety of incorporating curcumin nanoemulsion into\n                      <jats:italic>H. pylori<\/jats:italic>\n                      treatment.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hel.13110","type":"journal-article","created":{"date-parts":[[2024,7,13]],"date-time":"2024-07-13T02:45:24Z","timestamp":1720838724000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Boosting the Anti\u2010\n                    <i>Helicobacter<\/i>\n                    Efficacy of Azithromycin through Natural Compounds: Insights From In\u00a0Vitro, In\u00a0Vivo, Histopathological, and Molecular Docking Investigations"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1788-0038","authenticated-orcid":false,"given":"Mahmoud\u00a0M.","family":"Bendary","sequence":"first","affiliation":[{"name":"Department of Microbiology and Immunology, Faculty of Pharmacy Port Said University  Port Said Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arwa\u00a0R.","family":"Elmanakhly","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Faculty of Pharmacy Modern University of Technology and Information  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farag\u00a0M.","family":"Mosallam","sequence":"additional","affiliation":[{"name":"Drug Radiation Research Department, National Center for Radiation Research and Technology (NCRRT) Egyptian Atomic Energy Authority  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noaf\u00a0Abdullah\u00a0N.","family":"Alblwi","sequence":"additional","affiliation":[{"name":"Al Hadithah General Hospital Al\u2010Qurayyat  Al Hadithah Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasha\u00a0A.","family":"Mosbah","sequence":"additional","affiliation":[{"name":"Infection Control Unit Zagazig University Hospital  Zagazig Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walaa\u00a0A.","family":"Alshareef","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Faculty of Pharmacy 6th October University  Giza Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heba\u00a0M.\u00a0R.\u00a0M.","family":"Selim","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Science, College of Pharmacy AlMaarefa University  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majid","family":"Alhomrani","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratories Sciences, the Faculty of Applied Medical Science Taif University  Taif Saudi Arabia"},{"name":"Centre of Biomedical Science Research (CBSR), Deanship of Scientific Research Taif University  Taif Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulhakeem\u00a0S.","family":"Alamri","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratories Sciences, the Faculty of Applied Medical Science Taif University  Taif Saudi Arabia"},{"name":"Centre of Biomedical Science Research (CBSR), Deanship of Scientific Research Taif University  Taif Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nesreen\u00a0A.","family":"Safwat","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Faculty of Pharmacy Modern University of Technology and Information  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4930-792X","authenticated-orcid":false,"given":"Ahmed\u00a0M.\u00a0E.","family":"Hamdan","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, Faculty of Pharmacy University of Tabuk  Tabuk Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rana","family":"Elshimy","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Faculty of Pharmacy Alhram Canadian University  Giza Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,12]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"11","article-title":"Unidentified Curved Bacilli in the Stomach of Patients With Gastritis and Peptic Ulceration","volume":"113","author":"Marshall B. 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