, Volume 52, Issue 6, pp 549–558 | Cite as

Dietary PUFA Increase Apoptosis in Stomach of Patients with Dyspeptic Symptoms and Infected with H. pylori

  • Rasoul Sharifi
  • Mohammad Nouri
  • Akram Eidi
  • Zahra Noormohammadi
  • Homayun Dolatkhah
  • Masoud Shirmohammadi
Original Article


Drug-resistant strains of Helicobacter pylori and poor treatment response are the main reasons for the failure in eradicating it in patients. Polyunsaturated fatty acids (PUFA) have an inhibitory effect on bacterial growth. The aim of this study was to investigate the effect of PUFA in combination with standard triple therapy on apoptosis in H. pylori infected subjects with dyspeptic symptoms. This study was a double-blind clinical trial in which 34 H. pylori infected subjects with dyspeptic symptoms were randomly divided into two groups of 17 patients. The control group received standard triple therapy (amoxicillin, clarithromycin and omeprazole) and the experimental group received the standard therapy and PUFA for two weeks. Gene expression levels of caspase-3, BCL-2 and Bad proteins were studied with real-time PCR, while protein levels were quantified in frozen sections and using immunohistochemistry. Compared with the control group, a significant increase (p < 0.01) was observed in the expression of caspase-3 and Bad genes and a significant reduction (p < 0.05) in the expression of Bcl-2 gene. The protein level of active caspase-3 and Bad protein was significantly increased and the level of Bcl-2 protein was significantly decreased (p < 0.05). The results of this study show that oral administration of PUFA in combination with the standard triple therapy increased apoptosis in H. pylori-infected patients with dyspeptic symptoms. This increase in apoptosis may partly reduce drug resistance in these patients. Our results suggest inclusion of a dietary PUFA containing fatty acid supplement may improve treatment of patients that are refractory to the standard triple therapy.


Helicobacter pylori Unsaturated fatty acids Apoptosis Dyspeptic symptoms 



Alpha-linolenic acid


Apoptotic protease activating factor-1


Arachidonic acid


Apoptosis signal-regulating kinase 1




Docosahexaenoic acid


Eicosapentaenoic acid


Fas-associated death domain


Fast blood sugar


Fas ligand receptor


Gamma-linolenic acid


Inhibitor apoptotic protein




Oleic acid


Tris-buffered saline, 0.05% Tween20


Toll-like receptor-4


Tumor necrosis factor alpha


TNF receptor associated death domain



This project required extensive research and dedication from many individuals. Therefore we would like to extend our sincere gratitude to all of them and to the subjects for their participation in this study. First, we are thankful to the Tabriz Liver and Gastrointestinal Disease Research Center and Tehran Islamic Azad University Science and Research Branch for their financial and logistical support and for providing necessary guidance concerning project implementation. We are also grateful to the Tabriz Endoscopy Department of Imam Rewa and Shahid-Madani Hospital for provision of expertise and technical support in the implementation. Without their superior knowledge and experience, this study would lack quality of outcomes, and thus their support was essential.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interests regarding the publication of this paper.


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Copyright information

© AOCS 2017

Authors and Affiliations

  • Rasoul Sharifi
    • 1
  • Mohammad Nouri
    • 2
  • Akram Eidi
    • 1
  • Zahra Noormohammadi
    • 1
  • Homayun Dolatkhah
    • 3
  • Masoud Shirmohammadi
    • 4
  1. 1.Department of Biology, Science and Research BranchIslamic Azad UniversityTehranIran
  2. 2.Department of Clinical Biochemistry and Laboratories Medicine, Faculty of MedicineTabriz University of Medical SciencesTabrizIran
  3. 3.Liver and Gastrointestinal Disease Research CenterTabriz University of Medical SciencesTabrizIran
  4. 4.Department of Internal Medicine, Faculty of MedicineTabriz University of Medical SciencesTabrizIran

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