Helicobacter pyloriinfection-induced changes in the intestinal microbiota of 14-year-old or 15-year-old Japanese adolescents: a cross-sectional study

Abstract

ObjectiveThe relationship between Helicobacter pylori and the intestinal microbiota has not yet been clearly demonstrated in children and adolescents. The present study aimed at evaluating how H. pylori infection could affect the intestinal microbiota in adolescents using genetic analysis.DesignCross-sectional study.Setting and participantsWe included subjects from a longitudinal project involving H. pylori screening and treatment of junior high school third-grade students (aged 14 or 15 years) in Saga Prefecture. The study included a control group (n=79) and an H. pylori group (n=80) tested negative and positive for the anti-H. pylori antibody in the urine and H. pylori antigen in stool specimens, respectively.InterventionsThe intestinal microbiota was evaluated in stool specimens using 16S rRNA gene/DNA/amplicon sequencing with next-generation sequencing.Primary and secondary outcome measuresWe assessed alpha and beta diversity, just as well as relative abundances within the bacterial composition at the genus level in both groups.ResultsAs shown by the alpha diversity of the 16S rRNA gene/DNA/amplicon sequence data, the control group exhibited lower microbial species richness with lower alpha diversity compared with the H. pylori group (p<0.001). The beta diversity of the intestinal microbiota profile also differed between the two groups (p<0.01). The relative abundance of the Prevotella genus was higher in the H. pylori group (p<0.01) concomitant with a gain in body mass index (BMI) in the H. pylori group (p<0.01) compared with the control group.ConclusionH. pylori infection significantly affected the intestinal microbiota in Japanese adolescents. In addition, the prevalence of the Prevotella genus is concomitantly increased along with the BMI in H. pylori-infected students.Trial registration numberUMIN000028721.

Commentary: Association between Helicobacter pylori infection and metabolic syndrome and its components

“…We compared the fecal intestinal microbiota of H. pylori -infected and noninfected children ( 13 ). Most studies on the effects of H. pylori on the intestinal microbiota based on the analysis of fecal samples were conducted in adults, and data from children are lacking ( 21 ).…”

“…We analyzed the effects of H. pylori infection on the intestinal microbiota of children ( 13 ). This study included 80 H. pylori -infected and 79 noninfected 15-year-old adolescents.…”

Relationship between Helicobacter pylori infection and gastrointestinal microecology

“…A study on children showed that the abundance and diversity of gastrointestinal flora were higher in children without H. pylori infection, among which Proteobacteria, Bacteroides, Clostridium, etc., w ere more abundant ( Llorca et al., 2017 ). However, another study found that compared with uninfected children, H. pylori -positive children had an increased number of intestinal flora, such as Proteus, Clostridium, Firmicutes , and Prevotella ( Kakiuchi et al., 2021 ). Lu found that the diversity of intestinal flora in H. pylori -infected patients was higher, in which the abundance of Alistipes and Enterobacter cloacae increased and the abundance of Lachnoclostridium decreased.…”

Important Recommendations Regarding the Test-and-Treat Strategy for Helicobacter pylori Infection in Children

“…Third, we analyzed the effects of H. pylori infection on the intestinal microbiota of children. 10 This study included 80 H. pylori -infected and 79 noninfected 15-year-old adolescents. No significant differences were observed in sex, age, and body mass index between the 2 groups.…”

“…We speculate that this increase in the prevalence of Prevotella genus is associated with the increase in body mass index and glucose intolerance. 10 , 11 …”