Passing the “Acid Test”: Do Proton Pump Inhibitors Affect the Composition of the Microbiome?

Dong, Tien S.; Pisegna, Joseph R.

doi:10.1007/s10620-018-5273-3

Cited by 3 publications

(2 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several potential mechanisms may explain the change in the proximal intestinal pH that alters the gut microbiota. First, the increase in gastric pH due to anti-acid therapy may increase bacterial migration from the oral cavity to the intestinal lumen through decreased gastric acid-related bacterial killing [ 29 ], as observed by the increased oral microbiome in the fecal microbiota of PPI users, including genus Rothia and Streptococcus spp. [ 10 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

Anti-Acid Drug Treatment Induces Changes in the Gut Microbiome Composition of Hemodialysis Patients

Lin

Hung

et al. 2021

Microorganisms

View full text Add to dashboard Cite

Anti-acid drugs, proton pump inhibitor (PPI) and histamine-2 blocker (H2-blocker), are commonly prescribed to treat gastrointestinal disorders. These anti-acid drugs alter gut microbiota in the general population, but their effects are not known in hemodialysis patients. Hence, we investigated the microbiota composition in hemodialysis patients treated with PPIs or H2-blocker. Among 193 hemodialysis patients, we identified 32 H2-blocker users, 23 PPI users, and 138 no anti-acid drug subjects. Fecal samples were obtained to analyze the gut microbiome using 16S RNA amplicon sequencing. Differences in the microbial composition of the H2-blocker users, PPI users, and controls were assessed using linear discriminant analysis effect size and the random forest algorithm. The species richness or evenness (α-diversity) was similar among the three groups, whereas the inter-individual diversity (β-diversity) was different between H2-blocker users, PPI users, and controls. Hemodialysis patients treated with H2-blocker and PPIs had a higher microbial dysbiosis index than the controls, with a significant increase in the genera Provetella 2, Phascolarctobacterium, Christensenellaceae R-7 group, and Eubacterium oxidoreducens group in H2-blocker users, and Streptococcus and Veillonella in PPI users. In addition, compared to the H2-blocker users, there was a significant enrichment of the genera Streptococcus in PPI users, as confirmed by the random forest analysis and the confounder-adjusted regression model. In conclusion, PPIs significantly changed the gut microbiota composition in hemodialysis patients compared to H2-blocker users or controls. Importantly, the Streptococcus genus was significantly increased in PPI treatment. These findings caution against the overuse of PPIs.

show abstract

Section: Discussionmentioning

confidence: 99%

Anti-Acid Drug Treatment Induces Changes in the Gut Microbiome Composition of Hemodialysis Patients

Lin

Hung

et al. 2021

Microorganisms

View full text Add to dashboard Cite

show abstract

“…In fact, gastric acid has a powerful anti-microbial action and the majority of ingested micro-organisms are killed and do not reach the intestine. It must be also borne in mind that enteric pathogens differ in terms of their susceptibility to low gastric pH and the most acidlabile ones are represented by Vibrio cholerae, Salmonella, Campylobacter, Shigella and C. difficile [27] .…”

Section: Enteric Infectionsmentioning

confidence: 99%

Latest insights into the hot question of proton pump inhibitor safety – a narrative review

Savarino

Marabotto

Furnari

et al. 2020

Digestive and Liver Disease

View full text Add to dashboard Cite

Proton pump inhibitors

Schubert

2019

Current Opinion in Gastroenterology

View full text Add to dashboard Cite

Passing the “Acid Test”: Do Proton Pump Inhibitors Affect the Composition of the Microbiome?

Cited by 3 publications

References 13 publications

Anti-Acid Drug Treatment Induces Changes in the Gut Microbiome Composition of Hemodialysis Patients

Anti-Acid Drug Treatment Induces Changes in the Gut Microbiome Composition of Hemodialysis Patients

Latest insights into the hot question of proton pump inhibitor safety – a narrative review

Proton pump inhibitors

Contact Info

Product

Resources

About