Role of Gastric Microorganisms Other than Helicobacter pylori in the Development and Treatment of Gastric Diseases

Abstract

The microenvironment in the stomach is different from other digestive tracts, mainly because of the secretion of gastric acid and digestive enzymes, bile reflux, special mucus barrier, gastric peristalsis, and so on, which all contribute to the formation of antibacterial environment. Microecological disorders can lead to gastric immune disorders or lead to the decrease of dominant bacteria and the increase of the abundance and virulence of pathogenic microorganisms and then promote the occurrence of diseases. The body performs its immune function through innate and adaptive immunity and maintains microbial balance through the mechanism of immune homeostasis. Microecological imbalance can lead to the invasion of pathogenic microorganisms and damage mucosal barrier and immune system. The coexistence of gastric microorganisms (including viruses and fungi) may play a synergistic or antagonistic role in the pathogenesis of gastric diseases. Probiotics have the ability to compete with intestinal pathogens, increase the secretion of immunoglobulin A (IgA), stimulate the production of mucin, bacteriocin, and lactic acid, regulate the expression and secretion of cytokines, and regulate the growth of microbiota, which all have beneficial effects on the host microbial environment. At present, most studies focused on Helicobacter pylori, ignoring other stomach microbes and the overall stomach microecology. So, in this article, we reviewed advances in human gastric microecology, the relationship between gastric microecology and immunity or gastric diseases, and the treatment of probiotics in gastric diseases, in order to explore new area for further study of gastric microorganisms and treatment of gastric diseases.

Relationship between Helicobacter pylori infection and gastrointestinal microecology

“…( Bakhti and Latifi-Navid, 2021 ). At the genus level, Helicobacter and Haemophilus increase while Rosette decreases ( Duan et al., 2022 ). This phenomenon further shows that H. pylori has advantages over other flora.…”

In Search for Reasons behind Helicobacter pylori Eradication Failure–Assessment of the Antibiotics Resistance Rate and Co-Existence of Helicobacter pylori with Candida Species

“…Several studies have shown that Candida colonization of the gastric mucosa is associated with several gastric pathologies. Moreover, the co-existence of Candida species and H. pylori has been confirmed in several studies and a synergistic relationship between these two microorganisms in the pathogenesis of gastric diseases has been suggested [ 16 , 24 ]. Based on this long-standing relationship between the presence of Candida and H. pylori , we hypothesized that Candida presence in the gastric compartment could contribute not only to H. pylori pathologies but also to the resistance to the applied antibiotic therapy.…”

“…For a long time, H. pylori has been considered the only true inhabitant of the human stomach. However, despite the harsh environmental conditions, the existence of a thriving and dynamic gastric microbial community has been proven [ 24 , 25 , 26 , 27 ]. It is estimated that the stomach is inhabited by 10 2 –10 4 colony-forming units ( CFU )/mL [ 28 ].…”

“…It is estimated that the stomach is inhabited by 10 2 –10 4 colony-forming units ( CFU )/mL [ 28 ]. In addition to the bacterial communities, members of the fungal microbiota have also been identified in gastric biopsy samples, in the range of 0–10 2 CFU /mL [ 24 , 25 , 28 ]. Candida represents the most frequently isolated genus of yeasts, with C. albicans as the most frequently identified species [ 16 , 21 , 29 ].…”

Clostridium difficile and helicobacter pylori co-infection

“…Medical literature is full of data about H.Pylori mono infection treatment and Clostridium Difficilis mono infection treatment [7]. Furthermore, there are many researches about Clostridium Difficilis infection following H.Pylori eradication treatment [8]. However, there is paucity of information on Clostridium Defficilis and H.Pylori co infection.…”