H. pylori Eradication Treatment Alters Gut Microbiota and GLP-1 Secretion in Humans

Cornejo‐Pareja, Isabel; Martín‐Núñez, Gracia María; Roca-Rodríguez, M. M.; Cardona, Fernando; Coín‐Aragüez, Leticia; Sánchez-Alcoholado, Lidia; Gutiérrez-Repiso, Carolina; Muñoz-Garach, Araceli; Fernández‐García, José Carlos; Moreno-Indias, Isabel; Tinahones, Francisco J.

doi:10.3390/jcm8040451

Cited by 51 publications

(65 citation statements)

References 67 publications

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“…Cornejo‐Pareja et al observed a significant decrease in Actinobacteria after the administration of omeprazole, clarithromycin, and amoxicillin in patients with H pylori infection 19 . In this study, we observed a decrease in the microbial diversity of H pylori ‐infected patients after the treatment.…”

Section: Discussionsupporting

confidence: 63%

Effect of probiotics during vonoprazan‐containing triple therapy on gut microbiota in Helicobacter pylori infection: A randomized controlled trial

Kakiuchi

Mizoe²,

Yamamoto

et al. 2020

Helicobacter

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| INTRODUC TI ONHelicobacter pylori infection of the gastric epithelial mucosa affects approximately 50% of the population worldwide. In developing countries, H pylori infection has been observed in more than 90% of the population because this infection remains asymptomatic in early childhood, resulting in an enormous economic burden on healthcare resources. 1,2 Standard triple antibiotic therapy (proton-pump inhibitor (PPI) in combination with two of the following: amoxicillin, clarithromycin, or metronidazole) has been the preferred initial approach for H pylori eradication. 3 However, due to increased resistance of H pylori to clarithromycin and/or metronidazole, the eradication rate with triple therapy has reduced to <70% presently, down from >90% observed in the 1990s. 4 In Japan, decreased eradication of H pylori with the Abstract Background: Probiotics are beneficial to patients with Helicobacter pylori infections by modulating the gut microbiota. Biofermin-R (BFR) is a multiple antibiotic-resistant lactic acid bacteria preparation of Enterococcus faecium 129 BIO 3B-R and is effective in normalizing the gut microbiota when used in combination with antibiotics. This study aimed to determine the effect of BFR in combination with vonoprazan (VPZ)based therapy on gut microbiota. Methods: Patients with positive urinary anti-H pylori antibody test (primary test) and fecal H pylori antigen test (secondary test) were examined. Patients in group 1 (BFR − )received VPZ (20 mg twice daily), amoxicillin (750 mg twice daily), and clarithromycin (400 mg twice daily) for 7 days. Patients in group 2 (BFR + ) received BFR (3 tablets/ day) for 7 days, in addition to the aforementioned treatments. Following treatment, the relative abundance, α-diversity, and β-diversity of gut microbiota were assessed.Results: Supplementation with BFR prevented the decrease in α-diversity after eradication therapy (Day 7). β-diversity was similar between groups. The incidence rate of diarrhea was non-significantly higher in the BFR − than in the BFR + group (73.1% vs 56.5%; P = .361). Stool consistency was comparable in the BFR + group on Days 7 and 1 (3.86 ± 0.95 vs 3.86 ± 1.46; P = .415). Conclusion:Biofermin-R combined with VPZ-based therapy resulted in higher microbial α-strain diversity and suppressed stool softening during H pylori eradication therapy. K E Y W O R D S Biofermin-R, gut microbiota, Helicobacter pylori, vonoprazan S U PP O RTI N G I N FO R M ATI O N Additional supporting information may be found online in the Supporting Information section. How to cite this article: Kakiuchi T, Mizoe A, Yamamoto K, et al. Effect of probiotics during vonoprazan-containing triple therapy on gut microbiota in Helicobacter pylori infection: A randomized controlled trial. Helicobacter. 2020;25:e12690.

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Section: Discussionsupporting

confidence: 63%

Effect of probiotics during vonoprazan‐containing triple therapy on gut microbiota in Helicobacter pylori infection: A randomized controlled trial

Kakiuchi

Mizoe²,

Yamamoto

et al. 2020

Helicobacter

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“…We searched PubMed using the terms “Helicobacter”, “eradication” and “microbiota” for papers published from January 1, 2000, to March 12, 2020, in English. Sixteen studies using high‐throughput sequencing to assess alterations in the gut microbiota before and after H pylori eradication are summarized in Table 17‐32 . 10 publications focus on the impact of standard triple therapy and 5 studies address the long‐term (at least one year) effect after treatment.…”

Section: Introductionmentioning

confidence: 99%

Long‐term changes in the gut microbiota after 14‐day bismuth quadruple therapy in penicillin‐allergic children

Zhou

Miao

et al. 2020

Helicobacter

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Background Penicillin‐allergic children who are infected with Helicobacter pylori constitute a relatively common subgroup. We aimed to study the short‐term and long‐term effects of bismuth quadruple therapy on gut microbiota in penicillin‐allergic children. Methods We prospectively recruited treatment‐naive children with H pylori infection and H pylori‐negative asymptomatic children as healthy controls. Patients received 14‐day bismuth quadruple therapy consisting of omeprazole, clarithromycin, metronidazole, and bismuth. Fecal samples were collected at weeks 0, 2, 6, and 52. Alterations in the gut microbiota were analyzed by 16S rRNA gene sequencing. Results Twenty‐two subjects (14 gastritis patients, 8 duodenal ulcer patients) and 23 controls participated in this study. At week 2, alpha diversity was reduced in both gastritis (P < .05) and ulcer (except P = .16 with Chao 1 index) patients compared with baseline. Some changes persisted at week 6, and all were restored at week 52. Beta diversity was significantly altered 2 weeks after treatment in the gastritis and duodenal ulcer groups (P = .001, P = .002, respectively) and restored at weeks 6 and 52. The mean relative abundance of Bacteroidetes (P < .001, P = .005, respectively) decreased and that of Proteobacteria increased (P < .001, P = .03, respectively). All alterations recovered at week 6 and 52. In both the gastritis and ulcer groups at week 2, some beneficial bacteria were decreased including Bacteroides (P < .001 and P = .003), Faecalibacterium (P < .001 and P = .02), Phascolarctobacterium (P = .002 and P = .004), Roseburia ( P < .001 and P = .13), Bifidobacterium (P = .08 and P = .04), and Blautia (P < .001 and P = .002). Some detrimental bacteria were increased including Escherichia‐Shigella (P < .001 and P = .19), Klebsiella (P < .001, and P = .09), Enterococcus (P < .001 and P = .007), and Streptococcus (P = .002 and P = .004). The changes returned to almost the pre‐eradication level 1 year after therapy. Conclusion Bismuth quadruple therapy causes short‐term dysbiosis of the gut microbiota. Most changes recovered 1‐year post‐eradication, indicating the long‐term safety of H pylori therapy.

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“…Another challenge for the antibiotic therapy of H. pylori are side effects. These may occur in some patients, the combination of two antibiotics causes more damage to the host gastrointestinal microbiota and leads to the imbalanced microbial population associated with the proliferation of gastrointestinal pathogens [56][57][58]. Additionally, PPI induction decreases in gastric acid secretion may increase the mobility of these pathogens, enable them to circulate in the gastrointestinal tract [59,60].…”

Section: Antibiotic Therapymentioning

confidence: 99%

“…H. pylori infection alters both the gastric and intestinal microflora [110]. At the same time, the bactericidal effect of antibiotic use and the pH change caused by PPI can lead to more severe disorders [56][57][58][59][60]. Clinical studies have confirmed that H. pylori infection reduces the diversity of the stomach microbiota in children and adults, and this microbiota may not be restored after eradicating the pathogen [15,111].…”

Section: Gastrointestinal Theorymentioning

confidence: 99%

Using Probiotics as Supplementation for Helicobacter pylori Antibiotic Therapy

Yang

2020

IJMS

103

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Helicobacter pylori is a well-known pathogen that is highly prevalent in the world population, and H. pylori infection is potentially hazardous to humans because of its relationship to various gastrointestinal diseases, such as gastric ulcers, chronic gastritis, and gastric carcinoma. Therefore, the clinical guidelines recommend taking antibiotic therapy to eradicate the pathogen, which usually leads to the desired therapeutic effect. However, some failure cases of this therapy indicate that the increasing antibiotic resistance and side effects may affect the therapeutic effect. Here we propose that using probiotics as supplementation for antibiotic therapy may provide an extra help. Recent studies have shown that probiotic supplementation therapy has promising application prospects; it can enhance the antibiotic effect to achieve a better therapeutic result and maintain the balance of the host gastrointestinal microbiota. In summary, under global conditions of increasing H. pylori prevalence, probiotic supplementation therapy is worthy of further studies for future clinical application.

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H. pylori Eradication Treatment Alters Gut Microbiota and GLP-1 Secretion in Humans

Cited by 51 publications

References 67 publications

Effect of probiotics during vonoprazan‐containing triple therapy on gut microbiota in Helicobacter pylori infection: A randomized controlled trial

Effect of probiotics during vonoprazan‐containing triple therapy on gut microbiota in Helicobacter pylori infection: A randomized controlled trial

Long‐term changes in the gut microbiota after 14‐day bismuth quadruple therapy in penicillin‐allergic children

Using Probiotics as Supplementation for Helicobacter pylori Antibiotic Therapy

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