Evaluating the efficacy of curcumin and mastic gum enclosed in phospholipid-based lipid nanoparticles on Helicobacter pylori treatment using urea breath test delta values: A single- arm prospective pilot study

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Abstract
Background: Helicobacter pylori ( H. pylori ) infection remains a persistent health problem in Korea, where the prevalence of peptic ulcers and gastric cancer is high. This study aimed to determine whether phospholipid-based lipid nanoparticles containing curcumin and mastic gum are beneficial in the treatment of H. pylori infection. Materials and Methods: This was a prospective single-arm pilot study. Patients with confirmed H. pylori infection (delta >8.5) according to a 13 C-urea breath test (UBT) were included in this study. The study's primary endpoint was to determine the change in the delta UBT values after consuming curcumin-mastic concentrate powder three times a day for 10 days. The rates of H. pylori eradication with standard H. pylori eradication regimens, clarithromycin-based triple therapy, and bismuth quadruple therapy were evaluated. Results: A total of 25 patients participated in the study, with a mean age of 64.44±10.03 years, including 16 male (64.0%) and nine female (36.0%). After 10 days of consuming curcumin-mastic concentrate, the mean delta value of the UBT significantly decreased from 31.85±21.54 to 21.36±21.47 (mean difference=-10.49, P=0.018). Six (24.0%) patients achieved H. pylori eradication after ingesting a curcumin-mastic concentrate (delta value <2.5). The H. pylori eradication rate increased to 56.5% after clarithromycin-based triple therapy and to 85.0% after additional bismuth quadruple therapy. No adverse events related to curcumin-mastic concentrate intake were reported during the study period. Conclusions: Curcumin-mastic concentrate has been demonstrated to reduce H. pylori activity safely in humans. This study suggests that administering curcumin-mastic concentrate before H. pylori eradication treatment may improve eradication rates; however, further large randomized controlled trials are needed to confirm this finding.

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