The active bacterial assemblages of the upper GI tract in individuals with and without <i>Helicobacter</i> infection

Schulz, Christian; Schütte, Kerstin; Koch, Nadine; Vílchez-Vargas, Ramiro; Wos‐Oxley, Melissa L.; Oxley, Alan; Vital, Marius; Malfertheiner, Peter; Pieper, Dietmar H.

doi:10.1136/gutjnl-2016-312904

Cited by 166 publications

(201 citation statements)

References 38 publications

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“…A study by Klymiuk et al reported the effect of H pylori infection on the gastric microbiota and found that the number of Lactobacillus , Streptococcus , Acinetobacter , Prevotella, and Bacteroides genera was remarkedly decreased, while Helicobacter was increased in H pylori ‐positive samples. Another study compared the active bacterial communities in the stomach with and without Helicobacter infection and found that the stomach biopsies in individuals infected with H pylori had higher abundance of Helicobacter but lower abundance of Prevotella and Streptococcus . Because H pylori infection induces dysbiosis of the gastric microbiota, the present study demonstrated that eradication therapy could partially restore the balance of the microbiome.…”

Section: Discussionmentioning

confidence: 52%

The eradication of Helicobacter pylori restores rather than disturbs the gastrointestinal microbiota in asymptomatic young adults

et al. 2019

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Background The eradication of Helicobacter pylori (H pylori) has been suggested to reduce the risk of gastric cancer, but its impact on the gut microbiota has attracted public attention. This study aimed to investigate the short‐term and long‐term effects of bismuth quadruple therapy on both gastric and fecal microbiota. Methods Ten asymptomatic young adults with H pylori‐related gastritis were treated with bismuth quadruple therapy for 14 days, and 7 age‐matched adults without H pylori infection were enrolled as healthy controls. Both fecal and gastric mucosa samples were collected from H pylori‐positive patients at weeks 0, 6, and 26, while fecal samples were collected from healthy controls. The gastric and gut microbiota were analyzed by 16S rRNA gene sequencing. Results The structure of the gastric microbiota was significantly changed after the eradication of H pylori with increased alpha diversity over time. The relative abundance of H pylori sharply decreased from more than 70% to nearly 0% after treatment, while some beneficial bacteria, such as Lactobacillus and Bifidobacterium, were increased. The microbial diversity of gut microbiota was higher in H pylori‐infected patients than in healthy controls, which tended to decrease after eradication. The potentially beneficial gut bacteria Blautia and Lachnoclostridium were enriched at week 26 compared to week 0, while the pathogenic Alistipes were depleted to a level close to that of the healthy controls. Conclusions Bismuth quadruple therapy for H pylori eradication can restore the diversity of gastric microbiota with enrichment of beneficial bacteria. The composition of gut microbiota after H pylori eradication trends toward healthy status instead of becoming dysbiotic.

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Section: Discussionmentioning

confidence: 52%

The eradication of Helicobacter pylori restores rather than disturbs the gastrointestinal microbiota in asymptomatic young adults

et al. 2019

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“…Due to the stability of the DNA molecule even in the acidic environment of the stomach, 16S DNA sequencing does not provide information on whether the bacteria are still viable and metabolically active. Sequencing of 16S rRNA after reverse transcription to DNA is one approach to overcome this limitation and to allow for the characterization of the active bacterial assemblages . Using this technique, Parsons et al studied the gastric microbiota of 75 individuals with H pylori ‐induced atrophic gastritis, autoimmune atrophic gastritis and PPI use, conditions associated with similar levels of hypochlorhydria, but different risks and types of gastric cancer—specifically neuroendocrine and adenocarcinoma.…”

Section: Resultsmentioning

confidence: 95%

Systematic review: the effects of proton pump inhibitors on the microbiome of the digestive tract—evidence from next‐generation sequencing studies

Macke

Schulz

Koletzko

et al. 2020

Aliment Pharmacol Ther

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Background: Proton pump inhibitors (PPI) are widely used to treat acid-related disorders of the upper gastrointestinal tract. However, large observational studies have raised concerns about PPI-associated adverse events. In recent years, data from next-generation sequencing studies suggested that PPIs affect the composition of the intestinal microbiota, while a balanced gut microbiome is essential for maintaining health.Aim: To review the available evidence from next-generation sequencing studies on the effect of PPIs on the intestinal microbiome and to discuss possible implications of PPI-induced dysbiosis in health and disease.Methods: A systematic review was conducted following the recommendations of the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement. A PubMed query yielded 197 results. 19 publications met the prespecified eligibility criteria.Results: Twelve observational study cohorts with 708 PPI users and 11 interventional cohorts with 180 PPI users were included in the review. In most studies, PPI treatment did not affect microbiological richness and diversity, but was associated with distinct taxonomic alterations: In the upper gastrointestinal tract, PPI users showed overgrowth of orally derived bacteria, mostly Streptococcaceae (findings based on six independent cohorts with 126 PPI users). In faecal samples, PPIs increased multiple taxa from the orders Bacillales (eg, Staphylococcaceae), Lactobacillales (eg, Enterococcaceae, Lactobacillaceae, Streptococcaceae) and Actinomycetales (eg, Actinomycetaceae, Micrococcaceae), the families Pasteurellaceae and Enterobacteriaceae and the genus Veillonella. Taxa decreased by PPIs include Bifidobacteriaceae, Ruminococcaceae, Lachnospiraceae and Mollicutes (findings in faecal samples based on 19 independent cohorts with 790 PPI users). Conclusion: PPI use is associated with moderate alterations to upper and distal gut microbiota. The available data suggest that PPI-induced hypochlorhydria facilitates colonization of more distal parts of the digestive tract by upper gastrointestinal microbiota. MACKE Et Al 1 | INTRODUC TI ON: G A S TRI C ACID INHIB ITI ON AND ADVER S E EFFEC TS OF PPIS Gastric acid eliminates microorganisms, promotes the digestive process and facilitates the absorption of iron, calcium and vitamin B12. However, gastric acid also contributes to the development of mild and severe gastroduodenal pathologies. Proton pump inhibitor (PPIs) are the most effective therapy of acid-related diseases and are among the most commonly used drugs. 1 While generally considered a safe therapy, PPIs have been associated with numerous adverse effects in population-based observational studies conducted in recent years. These include cardiovascular and kidney disease, micronutrient deficiencies and osteoporosis, cognitive impairment and death. 2Most studies are retrospective and not hypothesis-driven in design, might be subject to significant confound and thus they cannot establish causality. 2,3 This is also the case for a recent study on ...

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“…Among these, an uncultured species related to the extremophile Deinococcus was discovered as well as members of the hypothetical phylum of enigmatic uncultured bacteria—TM7—referred to as ‘microbial dark matter’ . Several studies have also detected representatives of other uncultured bacteria designed as hypothetical phylum SR1 . Still, there was a significant overlap with previous cultivation findings, mainly because gastric microbes are oxygen tolerant and therefore more readily cultured and described compared to the predominantly anaerobic colonic microbiota.…”

Section: Introductionmentioning

confidence: 95%

Systematic review: gastric microbiota in health and disease

Rajilić‐Stojanović¹,

Figueiredo²,

Smet³

et al. 2020

Aliment Pharmacol Ther

127

112

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Background Helicobacter pylori is the most infamous constituent of the gastric microbiota and its presence is the strongest risk factor for gastric cancer and other gastroduodenal diseases. Although historically the healthy stomach was considered a sterile organ, we now know it is colonised with a complex microbiota. However, its role in health and disease is not well understood. Aim To systematically explore the literature on the gastric microbiota in health and disease as well as the gut microbiota after bariatric surgery. Methods A systematic search of online bibliographic databases MEDLINE/EMBASE was performed between 1966 and February 2019 with screening in accordance with Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Randomised controlled trials, cohort studies and observational studies were included if they reported next‐generation sequencing derived microbiota analysis on gastric aspirate/tissue or stool samples (bariatric surgical outcomes). Results Sixty‐five papers were eligible for inclusion. With the exception of H pylori‐induced conditions, overarching gastric microbiota signatures of health or disease could not be determined. Gastric carcinogenesis induces a progressively altered microbiota with an enrichment of oral and intestinal taxa as well as significant changes in host gastric mucin expression. Proton pump inhibitors usage increases gastric microbiota richness. Bariatric surgery is associated with an increase in potentially pathogenic proteobacterial species in patient stool samples. Conclusion While H pylori remains the single most important risk factor for gastric disease, its capacity to shape the collective gastric microbiota remains to be fully elucidated. Further studies are needed to explore the intricate host/microbial and microbial/microbial interplay.

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The active bacterial assemblages of the upper GI tract in individuals with and without Helicobacter infection

Cited by 166 publications

References 38 publications

The eradication of Helicobacter pylori restores rather than disturbs the gastrointestinal microbiota in asymptomatic young adults

The eradication of Helicobacter pylori restores rather than disturbs the gastrointestinal microbiota in asymptomatic young adults

Systematic review: the effects of proton pump inhibitors on the microbiome of the digestive tract—evidence from next‐generation sequencing studies

Systematic review: gastric microbiota in health and disease

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