Abstract
Background: Antibiotic therapy used to eradicate Helicobacter pylori has been associated with changes in plasma ghrelin and alterations in the gut microbiota. On the other hand, changes in ghrelin levels have been related to changes in gut microbiota composition. Our aim was to evaluate the relationship between changes in the gut microbiota and ghrelin levels in H. pylori infected patients who received antibiotic treatment for its eradication.Methods: A prospective case-control study that included forty H. pylori-positive patients who received eradication therapy (omeprazole, clarithromycin, and amoxicillin) and twenty healthy H. pylori antigen-negative participants. Patients were evaluated, including clinical, anthropometric and dietary variables, before and 2 months after treatment. Gut microbiota composition was analyzed through 16S rRNA amplicon sequencing (IlluminaMiSeq).Results: Changes in gut microbiota profiles and decrease in ghrelin levels were identified after H. pylori eradication treatment. Gut bacteria such as Bifidobacterium longum, Bacteroides, Prevotella, Parabacteroides distasonis, and RS045 have been linked to ghrelin levels fasting and/or post meals. Changes in the abundance of Lachnospiraceae, its genus Blautia, as well as Prevotella stercorea, and Megasphaera have been inversely associated with changes in ghrelin after eradication treatment.Conclusions: Eradication treatment for H. pylori produces changes in the composition of the intestinal microbiota and ghrelin levels. The imbalance between lactate producers such as Blautia, and lactate consumers such as Megasphaera, Lachnospiraceae, or Prevotella, could trigger changes related to ghrelin levels under the alteration of the eradication therapy used for H. pylori. In addition, acetate producing bacteria such as B. longum, Bacteroides, and P. distasonis could also play an important role in ghrelin regulation.
Highlights
Ghrelin, known as the hunger hormone, is predominantly produced in the stomach [1], but it is produced in other organs such as the pituitary, hypothalamus, adrenal gland, placenta, and pancreas [2, 3] as well as the small and large intestines [4]
No significant differences were found in body mass index (BMI), waist circumference, plasma glucose, plasma insulin, and triglycerides between study groups
high-density lipoprotein (HDL) cholesterol and glucagon-like peptide-1 (GLP-1) levels increased significantly (55.36 ± 16.36 vs. 52.97 ± 12.9, p = 0.021 and 4.2 ± 0.4 vs. 3.6 ± 0.3; p < 0.001, respectively) in patients after H. pylori eradication with antibiotic therapy, while Lowdensity lipoprotein (LDL) cholesterol levels increased in H. pylori-infected subjects compared to controls (121.45 ± 35.8 vs. 102.05 ± 34, p = 0.036) [17]
Summary
Known as the hunger hormone, is predominantly produced in the stomach [1], but it is produced in other organs such as the pituitary, hypothalamus, adrenal gland, placenta, and pancreas [2, 3] as well as the small and large intestines [4]. Serum ghrelin concentrations increase during fasting (when the stomach is empty), and decrease after eating [9]. Antibiotic therapy used to eradicate Helicobacter pylori has been associated with changes in plasma ghrelin and alterations in the gut microbiota. Changes in ghrelin levels have been related to changes in gut microbiota composition. Our aim was to evaluate the relationship between changes in the gut microbiota and ghrelin levels in H. pylori infected patients who received antibiotic treatment for its eradication
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