Advanced nano-delivery systems in H. pylori eradication: targeting, efficacy, and clinical translation.

Introduction: Helicobacter pylori infections demand innovative therapeutic strategies due to rising antibiotic resistance. This review consolidates recent advances in nanoparticle (NP)-based drug delivery systems engineered to optimize antimicrobial efficacy against H. pylori.

Areas covered: We critically examine the design, functionality, and performance of metallic, polymeric, lipid-based, and biomimetic nano-carriers, highlighting their advantages over conventional antibiotic delivery.

Expert opinion: Key innovations include: Lipid-based systems enabling synergistic co-delivery of hesperidin (0.064 μg mL⁻¹) and clarithromycin (0.15 mg mL⁻¹) for enhanced drug bioavailability; Polymeric NPs (e.g. rhamnolipid-chitosan hybrids) achieving deep biofilm penetration ( > 99% eradication) within gastric mucus at minimal inhibitory concentrations (32-132 µg/mL). These nanoplatforms demonstrate precision gastric-mucosa targeting, improved penetration of biological barriers, and controlled antimicrobial release. By maximizing localized drug delivery while minimizing systemic exposure, NP-based systems address critical limitations of current therapies, including resistance and microbiota disruption. We further emphasize the need for clinical validation to translate these delivery technologies into standardized treatments, ultimately reducing the global burden of H. pylori-associated diseases.