Table 4.

Activity and morphological effect of fatty acids and their derivatives on H. pylori.

Compound	H. pylori Strain(s)	Technic Determining Morphology	Technic Determining Viability	Main Results Covering the Morphological Transformation of H. pylori	Authors Interpretation	Bibliography
Docosahexaenoic acid	ATCC 700392, SS1	SEM	Culture	- Viability ↓ (<2 log, 48 h, MIC) - Mixed population of spiral and coccoid forms (48 h, MIC)	Inhibitory activity	[63]
Sodium butyrate	TK1402	SEM	Culture, PCR (eDNA detection)	- Stable viability (24 h, MBC) - Viability ↓ (4 log, 48 h, MBC) - Coccoid forms with blebs and cell envelope alternations (24 h, MBC) - ↑ eDNA amount (24 h, MBC)	Bactericidal activity	[64]
Zinc linolenate	G27	TEM	Culture, Luminescence (ATP level), Fluorescence (membrane integrity)	- Total viability ↓ (70 min, MIC) - Coccoid forms with membrane detachments, cytoplasmic content leakage, and vesiculation (2 h, MIC) - Membrane permeabilization (2 h, MIC) - ↓ iATP (2 h, MIC) and ↑ eATP (2 h, MIC)	Bactericidal activity	[65]
Liposomal linolenic acid	SS1	SEM	Culture, Fluorescence (membrane integrity)	- Total viability ↓ influenced by the morphology - MBC was higher for coccoid forms than spiral forms and killed cells more slowly (24 h, 400 µg/mL vs. 0.5 h, 67 µg/mL) - Disruption of bacterial membranes and cell clusters formation (0.5 h, MBC)	Bactericidal activity with coccoid forms being more tolerant	[43]

Symbols: decrease (↓), increase (↑). Abbreviations: extracellular DNA (eDNA), extracellular ATP (eATP), intracellular ATP (iATP), scanning electron microscopy (SEM), transmission electron microscopy (TEM), polymerase chain reaction (PCR), minimal inhibitory concentration (MIC), minimal bactericidal concentration (MBC).