Abstract
BackgroundHelicobacter pylori (Hp) eradication has been used for many years. Yet, the impact of this eradication on the normal gastric microflora is not well understood. In this study, we explored the effect of eradication on the stomach microbial community and its recovery after successful Hp eradication.MethodsAmong the 89 included patients, 23, 17, 40, and 9 were included in the Hp-negative, Hp-positive, successful eradication, and failed eradication groups, respectively. Four subgroups were further determined according to disease status (Hp-negative chronic gastritis [N-CG], Hp-negative atrophic gastritis [N-AG], successful-eradication chronic gastritis [SE-CG], and atrophic gastritis with successful eradication [SE-AG]). During the endoscopic examination, one piece of gastric mucosa tissue was obtained from the lesser curvature side of the gastric antrum and gastric corpus, respectively. In addition, 16S rDNA gene sequencing was used to analyze the gastric mucosal microbiome.ResultsIn the Hp-negative group, the gastric microbiota was dominated by five phyla: Firmicutes, Proteobacteria, Actinobacteria, Bacteroidetes, and Fusobacteria. After successfully eradicating Hp, the bacterial flora in the stomach recovered to a considerable extent. In the failed eradication group, the flora was similar to the flora in Hp-positive subjects based on the alpha and beta diversities. Among the groups, Curvibacter and Acinetobacter were enriched in the presence of Hp (i.e., failed eradication and Hp-positive groups), suggesting that these two genera could be used as biomarkers in the symbiotic flora in the presence of Hp. SE-CG was characterized by an increase in Firmicutes taxa and a decrease in Proteobacteria taxa compared with N-CG. SE-AG was characterized by a decrease in Firmicutes relative to N-AG. Finally, no differences were found in the pairwise comparisons of nitrate and nitrite reductase functions of the microflora among the four subgroups.ConclusionsAfter Hp infection, the diversity and relative abundance of gastric microflora were significantly decreased. Yet, gastric microbiota could be partially restored to the Hp-negative status after eradication. Still, this effect was incomplete and might contribute to the long-term risks.
Highlights
The gastrointestinal microbiome plays an important role in digestion, absorption, metabolism, immunity, and inhibition of pathogen colonization [1, 2]
We found that N-CG had greater richness and diversity than the other three subgroups, and there were no differences between the three subgroups (Fig. 1C)
The pathway involved in metabolism was overexpressed while the pathway involved in cell motility was inhibited in N-AG and SE-CG relative to N-CG (Fig. 6B)
Summary
The gastrointestinal microbiome plays an important role in digestion, absorption, metabolism, immunity, and inhibition of pathogen colonization [1, 2]. Helicobacter pylori (Hp) is the most important and most studied bacterium of the stomach [3, 4]. In China, the prevalence of Hp infection is 52–62% [10, 11] It is associated with various gastrointestinal diseases such as chronic gastritis, peptic ulcer, gastric mucosa-associated lymphoid tissue lymphoma, and gastric cancer [5,6,7, 12, 13]. Smoking and chronic nonsteroidal anti-inflammatory drug (NSAID) use significantly increase the risk of peptic ulcer disease in those infected with Hp. Hp eradication reduces the incidence of gastric cancer, and this benefit becomes more pronounced with increasing age [14,15,16]. We explored the effect of eradication on the stomach microbial community and its recovery after successful Hp eradication
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