# Postbiotics enhance the efficacy of derivative compound mouthwash against clinical Helicobacter pylori strains

## TL;DR

This study shows that a mouthwash containing postbiotics and glycerol monolaurate is highly effective against Helicobacter pylori with minimal harm to host cells.

## Contribution

The study introduces postbiotic-glycerol monolaurate mouthwash as a novel and effective formulation against H. pylori.

## Key findings

- Postbiotic-glycerol monolaurate mouthwash reduced H. pylori adhesion to host cells by 42.64-43.83%.
- The formulation eradicated H. pylori biofilm by 82.62% and reduced cagA expression by 112.60 fold.
- The mouthwash showed low cytotoxicity (<30%) and remained stable for 24 weeks.

## Abstract

A previous study indicated that poly L-lysine-glycerol monolaurate mouthwash reduced the virulence of Helicobacter pylori; however, these compounds are derivatives. Thus, this study aimed to compare the effects of postbiotics, postbiotic-glycerol monolaurate, and poly L-lysine-glycerol monolaurate mouthwashes against clinical H. pylori strains.

Postbiotics, Lacticaseibacillus paracasei SD1, L. rhamnosus SD4, and L. rhamnosus SD11 were examined for anti-bacterial activity and synergistic effects. Subsequently, mouthwashes containing postbiotics, postbiotic-glycerol monolaurate, and poly L-Lysine-glycerol monolaurate were prepared and evaluated for their ability to reduce H. pylori adhesion to host cells, suppress inflammation induced by H. pylori, eradicate biofilm, decrease cagA expression, and assess epithelial cell viability. The stability of the mouthwashes was evaluated every 4 weeks up to 24 weeks for their efficacy against H. pylori growth, biofilm eradication, and epithelial cell viability.

The postbiotics, L. paracasei SD1 and L. rhamnosus SD11, demonstrated significant anti-H. pylori activity, with synergistic effects observed in combinations with derivative compounds. Postbiotic-glycerol monolaurate mouthwashes exhibited higher efficacy in reducing H. pylori adhesion to host cells (42.64-43.83%), suppressing pro-inflammatory cytokines, eradicating biofilm (82.62% at 24 h), and reducing cagA expression (112.60 fold) compared to others. Such mouthwashes also displayed low cytotoxicity (< 30% for 15 min) to all cells tested. The stability was observed up to 24 weeks.

This in vitro study demonstrated that postbiotic-glycerol monolaurate mouthwash revealed the highest efficacy against H. pylori with low cytotoxicity to host cells. The stability lasted for 24 weeks.