Emulsifier may be key to treating ulcers

USA Today (Society for the Advancement of Education), Oct, 1996

Until the 1980s, scientists believed that bacteria could not survive in the stomach's acidic environment. Then they discovered that Heliocobacter pylori thrived in its mucus layer. As a result of that finding, stomach ulcers, once attributed to stress and high levels of stomach acid, now are considered infectious diseases, treatable with antibiotics.

In 1992, David Cave, associate professor of medicine at Tufts University and chief of gastroenterology at St. Elizabeth's Medical Center, Boston, asked Anne Kane, who directs the Intestinal Microbiology Core of the Digestive Disease Center at New England Medical Center, to provide him with large batches of H. pylori for his research into an acid-reducing protein generated by the bacteria. Kane was able to produce the bacteria easily in small batches, but the organism failed to multiply in big-batch fermenters. The bacteria is microaerophilic, meaning it needs some oxygen to grow, but not too much. At first, Kane thought her problem had to do with the oxygen mix. Eventually, she narrowed it down to an anti-foam agent routinely added to large-batch bacterial cultures to reduce bubbles.

"I thought it was the simethicone - the chemical in the anti-foam agent that dampens bubbles." She wanted to See if she was right by exposing the bacteria to pure simethicone, but couldn't because it is not soluble without an emulsifier. Kane needed to eliminate the emulsifier as a potential factor, so she took her investigation to the drug store.

"Simethicone is found in most antacids," she points out. At the drug store, she discovered a product, Mylicon, made for infants. It had no antacids, just anti-bubble properties. "That was as close to an anti-foam agent I was going to get."

With the help of the manufacturer, she identified the emulsifier in Mylicon and ordered some. To her surprise, when she added the pure emulsifier to a culture of H. pylori, she found it inhibited growth and actually killed the bacteria. Kane had solved the large-batch production problem, but also had stumbled onto something much more interesting - the possible therapeutic use of the emulsifier.

The current regime of attacking the stubborn bacteria with two or more antibiotics has some drawbacks, including nasty side effects and difficulty in taking multiple medications. A simple emulsifier therapy might prove much more effective, Kane theorizes. She and her colleagues are proceeding with tests of the emulsifier in infected stomachs. "Just because the emulsifier works in vitro [in the test tube] doesn't mean it will work in the stomach. But even it this particular agent doesn't prove to be a cure, we have discovered an Achilles heel of the organism."