Gut microbiota changes related to Helicobacter pylori eradication with vonoprazan containing triple therapy among adolescents: a prospective multicenter study

AbstractCurrently, it is unclear whether treating Helicobacter pylori (H. pylori) infection is safe among adolescents. This study aimed to evaluate the safety of H. pylori eradication therapy by examining gut microbiota changes in adolescents 3 months after the therapy. H. pylori-infected adolescents were enrolled in this study. Their stool samples were collected at the following three time points: before treatment, 1–2 days after completion of treatment, and time of eradication successful judgment. We assessed the relative abundance, alpha-diversity, and beta-diversity of the gut microbiota and adverse events. The number of isolated Actinobacteria decreased immediately after eradication therapy in the 16 students included in the study, and it returned to pretreatment condition at the eradication judgment point. There was no change in the relative abundance at genus level. The alpha-diversity was lost immediately after eradication therapy; however, it recovered at the time of eradication judgment, and it was restored to pretreatment condition. Meanwhile, none of the participants experienced serious adverse events. H. pylori eradication therapy is safe for adolescents with respect to gut microbiota changes associated with H. pylori eradication therapy. Therefore, further long-term evaluations of gut microbiota changes following eradication therapy are warranted.

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Gut Microbiota Changes During Helicobacter Pylori Eradication with Vonoprazan-Containing Triple Therapy Among Adolescents: A Prospective Multicenter Study in Japan

10.21203/rs.3.rs-37210/v1 ◽

2020 ◽

Author(s):

Toshihiko kakiuchi ◽

Kentaroh Yamamoto ◽

Ichiro Imamura ◽

Kazutoshi Hashiguchi ◽

Hiroharu Kawakubo ◽

...

Keyword(s):

Helicobacter Pylori ◽

Gut Microbiota ◽

Beta Diversity ◽

Medical Information ◽

Eradication Therapy ◽

Alpha Diversity ◽

University Hospital ◽

Healthy Children ◽

Serious Adverse Events

Abstract Background: Whether the screening and treatment of Helicobacter pylori infection are safe for children is debated in Japan. This study aimed to evaluate the safety of Helicobacter pylori eradication therapy by examining long-term changes in the gut microbiota during therapy among children.Methods: Children with anti-Helicobacter pylori antibody in the urine and Helicobacter pylori antigen in the feces were enrolled in this study. Their stool samples were collected at three time points, which were as follows: prior to treatment, 1–2 days after treatment, and time of judgment of eradication therapy. After treatment, the relative abundance, alpha-diversity, and beta-diversity of the gut microbiota were assessed.Results: In 16 students finally included in the study, the number of Actinobacteria isolated decreased immediately after eradication therapy, and it returned to pretreatment condition at the judgment point. There was no change at the genus level. The alpha-diversity was lost immediately after eradication therapy. However, it recovered at the time of eradication judgment, and it was restored before eradication therapy. Meanwhile, there was no change in beta-diversity, and none of the participants experienced serious adverse events.Conclusion: Helicobacter pylori eradication therapy is safe even for children in the view point of gut microbiota. Thus, further long-term evaluations of changes in the gut microbiota after eradication therapy and an assessment of healthy children without Helicobacter pylori must be performed. These will in turn promote screening and treatment among adolescents to prevent gastric cancer.Trial registration: This study was registered with the University Hospital Medical Information Network Clinical Trials Registry (no. UMIN000028726, https://upload.umin.ac.jp/cgi-bin/ctr_e/ctr_view.cgi?recptno=R000032873) on 18 August 2017.

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Dynamic changes in Antibiotic Resistance Genes and Gut Microbiota after H. Pylori Eradication Therapies

10.21203/rs.3.rs-777700/v1 ◽

2021 ◽

Author(s):

LINGLING WANG ◽

Haobin Yao ◽

Tereasa Tong ◽

KS Lau ◽

Suet Yi Leung ◽

...

Keyword(s):

Antibiotic Resistance ◽

Gut Microbiota ◽

Resistance Genes ◽

Eradication Therapy ◽

Antibiotic Resistance Genes ◽

Short Term ◽

Significant Difference ◽

Treatment Naïve ◽

Stool Samples ◽

H Pylori

Abstract Background: Short-term antibiotics exposure is associated with alterations in microbiota and antibiotic resistance genes (ARGs) in the human gut. While antibiotics are critical in the successful eradication of Helicobacter pylori, the short-term and long-term impacts on the composition and quantity of antibiotics resistance genes after H. pylori eradication is unclear. This study used whole genome shotgun metagenomic of stool samples to characterize the gut microbiota and ARGs, before and after H. pylori eradication therapy. Results: Forty-four H. pylori-infected patients were recruited including 21 treatment naïve patients who received clarithromycin-based triple therapy (CLA group) and 23 patients who failed previous therapies, in which 10 received levofloxacin-based quadruple therapy [LEVO group] and 13 received other combinations [OTHER group] in the current study. Stool samples were collected at baseline (before current treatment), 6-week and 6-month after eradication therapy. At baseline, there was only a slight difference among the three groups on ARGs and gut microbiota. After eradication therapy, there was a transient but significant increase in gut ARGs 6-week post-therapy, among which the LEVO group had the most significant ARGs alteration compared to other two groups. For treatment naïve patients, those with higher ARG richness and ErmF abundance were prone to fail CLA eradication. For gut microbiota, the bacteria richness decreased at 6-week and there was a significant difference in microbiota community among the three groups at 6-week. Conclusions: Our findings demonstrated the dynamic alterations in gut microbiota and ARGs induced by different eradication therapies, which could influence the choices of antibiotics in eradication therapy.

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The impact of probiotics supplementation on gut microbiota after Helicobacter pylori eradication: a multicenter, open-label, randomised trial

10.21203/rs.3.rs-18049/v1 ◽

2020 ◽

Author(s):

Bo Tang ◽

Li Tang ◽

Cheng Huang ◽

Chuan Tian ◽

Ling Chen ◽

...

Keyword(s):

Helicobacter Pylori ◽

Gut Microbiota ◽

Randomised Trial ◽

Eradication Therapy ◽

Open Label ◽

Quadruple Therapy ◽

Alpha And Beta Diversity ◽

Group A ◽

H Pylori ◽

Group B

Abstract Background: Helicobacter pylori (H. pylori) eradication therapy may lead to the perturbation of gut microbiota. The role of probiotics in gut microbiota during eradication therapy is still debated. Design: This was a multicentre, open-label, randomised trial done at seven hospitals in China. 162 patients were enrolled, 79 patients were randomly divided into group A (bismuth quadruple therapy), and 83 patients were randomly subjected into group B (bismuth quadruple therapy supplemented with Medilac-S). Faecal samples were collected before treatment and 2 weeks, 4 weeks, 6 weeks, and 8 weeks after eradication therapy. Gut microbiota was analyzed by 16S rRNA high-throughput sequencing. This trial is complete and registered with Chinese Clinical Trial Registry (Chictr.org.cn, ChiCTR1900022116). Results: The eradication rates of group A and group B were 82.43% and 87.01%, respectively (P>0.05). Compared with baseline, alpha and beta diversity was significantly altered 2 weeks after eradication in both group A and group B, which was restored at week 8. There were no significant differences in alpha and beta diversity between the two groups. Bismuth quadruple therapy resulted in enrichment of some detrimental bacteria taxa such as Klebsiella and Streptococcus that were not recovered by week 8. Probiotics supplementation could rapidly restore the taxa levels of Klebsiella and Streptococcus by week 4 after eradication, and increase the beneficial taxa of Bacillus and Lactobacillales. Functional analysis revealed that lipopolysaccharide biosynthesis and polymyxin resistance pathways were significantly enriched after eradication therapy, while probiotics supplementation mainly enriched the cofactors and vitamins metabolism pathways. Several detrimental taxa were identified to be correlated with features of older age, alcohol use and high BMI, while probiotics supplementation could effectively restore the adverse impact in patients with these characteristics.Conclusion: Probiotics supplementation is beneficial for patients during H. pylori eradication, especially for patients with older age, alcohol drinking, and obesity, which might obtain the maximum benefits.

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Eradication of Helicobacter Pylori Improves Dyspepsia Symptoms in Elderly People

10.21203/rs.3.rs-118169/v1 ◽

2020 ◽

Author(s):

Ikko Tanaka ◽

Shoko Ono ◽

Yoshihiko Shimoda ◽

Masaki Inoue ◽

Sayoko Kinowaki ◽

...

Keyword(s):

Helicobacter Pylori ◽

Elderly Patients ◽

Eradication Rate ◽

Epigastric Pain ◽

Eradication Therapy ◽

Serious Adverse Events ◽

Postprandial Fullness ◽

Abdominal Symptoms ◽

H Pylori ◽

One Year

Abstract BackgroundTherapy for eradication of Helicobacter pylori (H. pylori) improves symptoms of H. pylori-associated dyspepsia (HPD), but the effects of eradication in elderly patients are unclear. AimsTo evaluate the outcomes of eradication therapy and effects of eradication on dyspepsia symptoms in elderly patients.MethodsThis retrospective study included 496 patients who received H. pylori eradication therapy. The patients were divided into a group of elderly patients (group E: ≧ 65 years old) and a group of non-elderly patients (group N: < 65 years old). Abdominal symptoms were evaluated using a questionnaire about 12 abdominal symptoms before eradication and after eradication (1-2 months and more than one year). Dyspepsia was defined as a score of 4 points or more score for at least one of 4 items (postprandial fullness, early satiety, epigastric pain, and hunger pain).ResultsSuccesful H. pylori eradication rate in group E was significantly lower than that in group N (74.7 % vs. 84.4 %, P < 0.05) and it was remarkable in the 3rd-line therapy (59.7 % vs. 76.5 %, P < 0.05). Serious adverse events did not occur in either groups. Successful eradication improved symptoms in patients with dyspepsia in both groups within 2 months (70.3% of the patients in group N, 76.2% of the patients in group E) and decrease of GOS score lasted for more than 1 year.ConclusionsH. pylori eradication would be recommend for elderly patients with dyspepsia symptoms.

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Gut Microbiota: The Missing Link Between Helicobacter pylori Infection and Metabolic Disorders?

Frontiers in Endocrinology ◽

10.3389/fendo.2021.639856 ◽

2021 ◽

Vol 12 ◽

Author(s):

Gracia M. Martin-Nuñez ◽

Isabel Cornejo-Pareja ◽

Mercedes Clemente-Postigo ◽

Francisco J. Tinahones

Keyword(s):

Helicobacter Pylori ◽

Gut Microbiota ◽

Metabolic Diseases ◽

Eradication Therapy ◽

Future Research ◽

Diabetic Patients ◽

Peptic Ulcers ◽

Hormonal Modulation ◽

H Pylori ◽

The Impact

Helicobacter pylori (H. pylori) is a gram-negative bacterium that infects approximately 4.4 billion individuals worldwide. Although the majority of infected individuals remain asymptomatic, this bacterium colonizes the gastric mucosa causing the development of various clinical conditions as peptic ulcers, chronic gastritis and gastric adenocarcinomas and mucosa-associated lymphoid tissue lymphomas, but complications are not limited to gastric ones. Extradigestive pathologies, including metabolic disturbances such as diabetes, obesity and nonalcoholic fatty liver disease, have also been associated with H. pylori infection. However, the underlying mechanisms connecting H. pylori with extragastric metabolic diseases needs to be clarified. Notably, the latest studies on the topic have confirmed that H. pylori infection modulates gut microbiota in humans. Damage in the gut bacterial community (dysbiosis) has been widely related to metabolic dysregulation by affecting adiposity, host energy balance, carbohydrate metabolism, and hormonal modulation, among others. Taking into account that Type 2 diabetic patients are more prone to be H. pylori positive, gut microbiota emerges as putative key factor responsible for this interaction. In this regard, the therapy of choice for H. pylori eradication, based on proton pump inhibitor combined with two or more antibiotics, also alters gut microbiota composition, but consequences on metabolic health of the patients has been scarcely explored. Recent studies from our group showed that, despite decreasing gut bacterial diversity, conventional H. pylori eradication therapy is related to positive changes in glucose and lipid profiles. The mechanistic insights explaining these effects should also be addressed in future research. This review will deal with the role of gut microbiota as the linking factor between H. pylori infection and metabolic diseases, and discussed the impact that gut bacterial modulation by H. pylori eradication treatment can also have in host’s metabolism. For this purpose, new evidence from the latest human studies published in more recent years will be analyzed.

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Efficacy and safety of the use of rebamipide in the scheme of triple eradication therapy of Helicobacter pylori infection: a prospective randomized comparative study

Terapevticheskii arkhiv ◽

10.26442/terarkh201890827-32 ◽

2018 ◽

Vol 90 (8) ◽

pp. 27-32 ◽

Cited By ~ 9

Author(s):

D N Andreev ◽

I V Maev ◽

D T Dicheva ◽

A A Samsonov ◽

E V Partzvania-Vinogradova

Keyword(s):

Helicobacter Pylori ◽

Gastric Ulcer ◽

Adverse Events ◽

Comparative Study ◽

Eradication Therapy ◽

Helicobacter Pylori Infection ◽

Inflammatory Activity ◽

The Third ◽

Biopsy Specimens ◽

H Pylori

Purpose of the study. To evaluate the effectiveness and safety of the use of rebamipide as part of the triple eradication therapy (ET) scheme of Helicobacter pylori infection. Materials and methods. A prospective, randomized comparative study included 94 patients with uncomplicated H. pylori-associated stomach / duodenal ulcer. In the process of randomization, patients are divided into three groups depending on the intended therapy. The first group (n=36) received a classical triple scheme of the first-line ET (omeprazole 20 mg twice a day, amoxicillin 1000 mg twice a day, clarithromycin 500 mg twice a day) for 10 days. Patients of the second group (n=33) were assigned a classical triple scheme of ET with the inclusion of rebamipide (omeprazole 20 mg twice a day, amoxicillin 1000 mg twice a day, clarithromycin 500 mg twice a day, rebamipide 100 mg 3 times a day day) for 10 days. Patients of the third group (n=25) were assigned a classical triple scheme of ET with the inclusion of rebamipide (omeprazole 20 mg twice a day, amoxicillin 1000 mg twice a day, clarithromycin 500 mg twice a day, rebamipide 100 mg 3 times a day) in for 10 days, with the prolongation of the administration of rebamipide for the next 20 days. The effectiveness of ET was determined by the respiratory test after 6 weeks after the end of treatment. Adverse events were recorded by patients in specially developed diaries. All patients with gastric ulcer at the 6th week underwent a histological examination of the biopsy specimens of the antrum and the body of the stomach, assessing the inflammatory activity of the process on a point system in accordance with the updated Sydney system. Results and discussion. Efficiency of H. pylori eradication in the first group was 77.7% (ITT), 82.3% (PP), in the second group - 81.8% (ITT), 84.4% (PP), and in the third group - 84% (ITT), 87.5% (PP). The use of rebamipide in the triple ET regimen was associated with an increase in H. pylori eradication efficiency, both with simultaneous use with the scheme [odds ratio (OR) 1.16; 95% confidence interval (CI) 0.32-4.24], and with subsequent prolonged admission (OR 1.5, 95% CI 0.34-6.7). A somewhat more pronounced dynamics of the epithelization of erosive and ulcerative changes in the mucous membrane of the stomach and duodenum to the 21st and 28th days in the third group of patients was noted. The incidence of adverse events between the groups was comparable: 22.2% in the first group, 24.2% in the second group and 20% in the third group. In the pathomorphological evaluation of biopsy specimens of patients with gastric ulcer at the 6th week after the treatment, significant differences were revealed between the first and third groups in terms of the inflammatory activity in the antrum stomach (2±0.63 vs. 1.4±0.52; p=0,0399). The conclusion. The inclusion of rebamipide in the classical triple scheme of H. pylori ET increases the effectiveness of treatment and does not affect the safety profile. In the post-eradication period, it is advisable to continue the use of rebamipide to potentiate the repair of the gastric mucosa and regress the inflammatory processes.

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Efficacy of Helicobacter pylori eradication therapy for functional dyspepsia: updated systematic review and meta-analysis

Gut ◽

10.1136/gutjnl-2021-326583 ◽

2022 ◽

pp. gutjnl-2021-326583

Author(s):

Alexander C Ford ◽

Evangelos Tsipotis ◽

Yuhong Yuan ◽

Grigorios I Leontiadis ◽

Paul Moayyedi

Keyword(s):

Helicobacter Pylori ◽

Adverse Events ◽

Functional Dyspepsia ◽

Meta Analysis ◽

Pearson Correlation ◽

Cochrane Review ◽

Eradication Therapy ◽

Number Needed To Treat ◽

H Pylori ◽

Randomised Controlled

ObjectiveFunctional dyspepsia (FD) is a chronic disorder that is difficult to treat. Helicobacter pylori may contribute to its pathophysiology. A Cochrane review from 2006 suggested that eradication therapy was beneficial, but there have been numerous randomised controlled trials (RCTs) published since. We evaluated impact of eradication therapy on both cure and improvement of FD, as well as whether any benefit was likely to arise from eradication of H. pylori.DesignWe searched the medical literature through October 2021 to identify RCTs examining efficacy of eradication therapy in H. pylori-positive adults with FD. The control arm received antisecretory therapy or prokinetics, with or without placebo antibiotics, or placebo alone. Follow-up was for ≥3 months. We pooled dichotomous data to obtain a relative risk (RR) of symptoms not being cured or symptoms not improving with a 95% CI. We estimated the number needed to treat (NNT).ResultsTwenty-nine RCTs recruited 6781 H. pylori-positive patients with FD. Eradication therapy was superior to control for symptom cure (RR of symptoms not being cured=0.91; 95% CI 0.88 to 0.94, NNT=14; 95% CI 11 to 21) and improvement (RR of symptoms not improving=0.84; 95% CI 0.78 to 0.91, NNT=9; 95% CI 7 to 17). There was no significant correlation between eradication rate and RR of FD improving or being cured (Pearson correlation coefficient=−0.23, p=0.907), but the effect was larger in patients with successful eradication of H. pylori than with unsuccessful eradication (RR=0.65; 95% CI 0.52 to 0.82, NNT=4.5, 95% CI 3 to 9). Adverse events (RR=2.19; 95% 1.10 to 4.37) and adverse events leading to withdrawal (RR=2.60; 95% CI 1.47 to 4.58) were more common with eradication therapy.ConclusionThere is high quality evidence to suggest that H. pylori eradication therapy leads to both cure and improvement in FD symptoms, although the benefit is modest.

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Helicobacter pylori Eradication Therapy Affect the Gut Microbiota and Ghrelin Levels

Frontiers in Medicine ◽

10.3389/fmed.2021.712908 ◽

2021 ◽

Vol 8 ◽

Author(s):

Gracia Mª Martín-Núñez ◽

Isabel Cornejo-Pareja ◽

Mercedes Clemente-Postigo ◽

Francisco J. Tinahones ◽

Isabel Moreno-Indias

Keyword(s):

Helicobacter Pylori ◽

Gut Microbiota ◽

Bifidobacterium Longum ◽

Eradication Therapy ◽

Amplicon Sequencing ◽

Microbiota Composition ◽

16S Rrna Amplicon Sequencing ◽

H Pylori ◽

The Relationship ◽

Gut Microbiota Composition

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.

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Strongyloides stercoralis Infestation in a Child: How a Nematode Can Affect Gut Microbiota

International Journal of Molecular Sciences ◽

10.3390/ijms22042131 ◽

2021 ◽

Vol 22 (4) ◽

pp. 2131

Author(s):

Stefania Pane ◽

Anna Sacco ◽

Andrea Iorio ◽

Lorenza Romani ◽

Lorenza Putignani

Keyword(s):

Gut Microbiota ◽

Bacterial Species ◽

Alpha Diversity ◽

Strongyloides Stercoralis ◽

Pulmonary Involvement ◽

Diversity Indices ◽

Parasite Infection ◽

Intestinal Nematode ◽

Immune Mediated ◽

Stool Samples

Background: Strongyloidiasis is a neglected tropical disease caused by the intestinal nematode Strongyloides stercoralis and characterized by gastrointestinal and pulmonary involvement. We report a pediatric case of strongyloidiasis to underline the response of the host microbiota to the perturbation induced by the nematode. Methods: We performed a 16S rRNA-metagenomic analysis of the gut microbiota of a 7-year-old female during and after S. stercolaris infection, investigating three time-point of stool samples’ ecology: T0- during parasite infection, T1- a month after parasite infection, and T2- two months after parasite infection. Targeted-metagenomics were used to investigate ecology and to predict the functional pathways of the gut microbiota. Results: an increase in the alpha-diversity indices in T0-T1 samples was observed compared to T2 and healthy controls (CTRLs). Beta-diversity analysis showed a shift in the relative abundance of specific gut bacterial species from T0 to T2 samples. Moreover, the functional prediction of the targeted-metagenomics profiles suggested an enrichment of microbial glycan and carbohydrate metabolisms in the T0 sample compared with CTRLs. Conclusions: The herein report reinforces the literature suggestion of a putative direct or immune-mediated ability of S. stercolaris to promote the increase in bacterial diversity.

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MALT lymphoma: epidemiology, clinical diagnosis and treatment

Journal of Medicine and Life ◽

10.25122/jml-2018-0035 ◽

2018 ◽

Vol 11 (3) ◽

pp. 187-193 ◽

Cited By ~ 13

Author(s):

Petruta Violeta Filip ◽

◽

Denisa Cuciureanu ◽

Laura Sorina Diaconu ◽

Ana Maria Vladareanu ◽

...

Keyword(s):

Helicobacter Pylori ◽

B Cell ◽

Malt Lymphoma ◽

Cell Lymphoma ◽

Gastric Lymphoma ◽

Eradication Therapy ◽

B Cell Lymphoma ◽

Gastric Malt Lymphoma ◽

H Pylori

Primary gastric lymphoma (PGL) represents a rare pathology, which can be easily misdiagnosed because of unspecific symptoms of the digestive tract. Histologically, PGL can vary from indolent marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) to aggressive diffuse large B-cell lymphoma (DLBCL). During the years, clinical trials revealed the important role of Helicobacter pylori (H. pylori) in the pathogenesis of gastric MALT lymphoma. Infection with Helicobacter pylori is an influential promoter of gastric lymphomagenesis initiation. Long-term studies revealed that eradication therapy could regress gastric lymphomas.

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