The impact of Helicobacter pylori infection, eradication therapy and probiotic supplementation on gut microenvironment homeostasis: An open-label, randomized clinical trialResearch in context

Luyi Chen; Wenli Xu; Allen Lee; Jiamin He; Bixia Huang; Wenfang Zheng; Tingting Su; Sanchuan Lai; Yanqin Long; Hua Chu; Yujia Chen; Lan Wang; Kan Wang; Jianmin Si; Shujie Chen

EBioMedicine (Sep 2018)

The impact of Helicobacter pylori infection, eradication therapy and probiotic supplementation on gut microenvironment homeostasis: An open-label, randomized clinical trialResearch in context

Luyi Chen,
Wenli Xu,
Allen Lee,
Jiamin He,
Bixia Huang,
Wenfang Zheng,
Tingting Su,
Sanchuan Lai,
Yanqin Long,
Hua Chu,
Yujia Chen,
Lan Wang,
Kan Wang,
Jianmin Si,
Shujie Chen

Affiliations

Luyi Chen: Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Institute of Gastroenterology, Zhejiang University, Hangzhou, Zhejiang, China
Wenli Xu: Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Institute of Gastroenterology, Zhejiang University, Hangzhou, Zhejiang, China
Allen Lee: Division of Gastroenterology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA
Jiamin He: Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Institute of Gastroenterology, Zhejiang University, Hangzhou, Zhejiang, China
Bixia Huang: Institute of Gastroenterology, Zhejiang University, Hangzhou, Zhejiang, China; Department of Gastroenterology, Xinchang Hospital of Traditional Chinese Medicine of Zhejiang, Shaoxing, China
Wenfang Zheng: Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Institute of Gastroenterology, Zhejiang University, Hangzhou, Zhejiang, China
Tingting Su: Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Institute of Gastroenterology, Zhejiang University, Hangzhou, Zhejiang, China
Sanchuan Lai: Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Institute of Gastroenterology, Zhejiang University, Hangzhou, Zhejiang, China
Yanqin Long: Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
Hua Chu: Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
Yujia Chen: Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
Lan Wang: Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Institute of Gastroenterology, Zhejiang University, Hangzhou, Zhejiang, China
Kan Wang: Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Institute of Gastroenterology, Zhejiang University, Hangzhou, Zhejiang, China
Jianmin Si: Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Institute of Gastroenterology, Zhejiang University, Hangzhou, Zhejiang, China; Corresponding authors at: Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No. 3 East Qingchun Road, Hangzhou 310016, China.
Shujie Chen: Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Institute of Gastroenterology, Zhejiang University, Hangzhou, Zhejiang, China; Corresponding authors at: Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No. 3 East Qingchun Road, Hangzhou 310016, China.

Journal volume & issue: Vol. 35
pp. 87 – 96

Abstract

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Background: Helicobacter pylori (H. pylori) infection is associated with remodeling of gastric microbiota. However, comprehensive analyses of the impact of H. pylori infection, eradication therapy and probiotic supplementation on gut microbiota are still lacking. We aimed to provide evidence for clinical decision making. Methods: Seventy H. pylori-positive and 35 H. pylori-negative patients (group C) were enrolled. H. pylori-positive patients were randomly assigned to group A (14-day bismuth-containing quadruple therapy) and group B (quadruple therapy supplemented with Clostridium butyricum). Stool samples of group A and B were collected on day 0, 14 and 56 while stool samples of group C were collected on day 0. Gut microbiota was investigated by 16S rRNA sequencing. Findings: The Sobs index (richness estimator) was significantly higher in H. pylori-positive samples than H. pylori-negative samples (p < .05). Several metabolic pathways were more abundant in H. pylori-positive communities while some disease-associated pathways had higher potential in H. pylori-negative community through KEGG pathway analysis. Abundances of most butyrate-producing bacteria significantly decreased, while several detrimental bacteria increased after eradication therapy. Probiotic supplementation was associated with improved gastrointestinal symptoms as well as increased Bacteroidetes:Firmicutes ratio. Interpretation: While H. pylori infection may not be necessarily detrimental in all patients, eradication of H. pylori was associated with widespread changes in gut microbial ecology and structure. Probiotic supplementation could relieve more gastrointestinal symptoms by inducing alterations in gut microbiota and host immune responses. As such, the decision to eradicate H. pylori should be based on comprehensive analysis of individual patients. Keywords: Helicobacter pylori, Gut microbiota, 16S rRNA sequencing, Clostridium butyricum, Bismuth-containing quadruple therapy

Published in EBioMedicine

ISSN: 2352-3964 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Medicine (General)
Website: http://www.journals.elsevier.com/ebiomedicine/

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