{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T16:33:22Z","timestamp":1793291602490,"version":"4.5.0"},"reference-count":116,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:p>\n                    The rising prevalence of antibiotic-resistant\n                    <jats:italic>Helicobacter pylori<\/jats:italic>\n                    has become a major obstacle to the success of conventional eradication therapies, including triple and quadruple regimens combining antibiotics with proton pump inhibitors. There is an urgent need for safe and effective ad-junctive strategies to restore antibiotic efficacy. Probiotics, particularly\n                    <jats:italic>Bifidobacterium<\/jats:italic>\n                    species, have gained increasing attention for their potential to enhance\n                    <jats:italic>H. pylori<\/jats:italic>\n                    eradication and mitigate treatment-associated adverse effects. This review provides a comprehensive synthesis of the key molecular mechanisms driving\n                    <jats:italic>H. pylori<\/jats:italic>\n                    antibiotic resistance, including chromosomal mutations, altered expression of outer membrane proteins, enhanced efflux pump activity, biofilm formation, and morphological transition into dormant coccoid forms. Importantly, we critically examine the emerging evidence on how\n                    <jats:italic>Bifidobacterium<\/jats:italic>\n                    may synergize with antibiotics to counteract these resistance mechanisms. The proposed mechanisms include the secretion of bioactive metabolites (e.g., organic acids and antimicrobial peptides), reinforcement of the gastric mucosal barrier, modulation of host immune responses, and competitive exclusion of\n                    <jats:italic>H. pylori<\/jats:italic>\n                    . By integrating these mechanistic in-sights, this review highlights the potential of\n                    <jats:italic>Bifidobacterium<\/jats:italic>\n                    as a promising adjunctive therapeutic agent for overcoming antibiotic-resistant\n                    <jats:italic>H. pylori<\/jats:italic>\n                    infections and calls for more rigorous, strain-specific clinical investigations to translate these findings into practice.\n                  <\/jats:p>","DOI":"10.3389\/fmicb.2026.1911939","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T11:59:07Z","timestamp":1790596747000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Potential mechanisms of Bifidobacterium-mediated synergistic antibiotic eradication of drug-resistant Helicobacter pylori"],"prefix":"10.3389","volume":"17","author":[{"given":"Linna","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Digestive Endoscopy Center, The Second Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Digestive Endoscopy Center, The Second Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingyu","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Digestive Endoscopy Center, The Second Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuang","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Digestive Endoscopy Center, The Second Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijuan","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Digestive Endoscopy Center, The Second Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruifeng","family":"Duan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Digestive Endoscopy Center, The Second Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e0025821","DOI":"10.1128\/cmr.00258-21","article-title":"Helicobacter pylori infection, its laboratory diagnosis, and antimicrobial resistance: a perspective of clinical relevance","volume":"35","author":"Ansari","year":"2022","journal-title":"Clin. 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