title: Effects of Proton Pump Inhibitors on the Gastric Mucosa-Associated Microbiota in Dyspeptic Patients.
abstract: Besides being part of anti-Helicobacter pylori treatment regimens, proton pump inhibitors (PPIs) are increasingly being used to treat dyspepsia. However, little is known about the effects of PPIs on the human gastric microbiota, especially those related to H. pylori infection. The goal of this study was to characterize the stomach microbial communities in patients with dyspepsia and to investigate their relationships with PPI use and H. pylori status. Using 16S rRNA gene pyrosequencing, we analyzed the mucosa-associated microbial populations of 24 patients, of whom 12 were treated with the PPI omeprazole and 9 (5 treated and 4 untreated) were positive for H. pylori infection. The Proteobacteria, Firmicutes, Bacteroidetes, Fusobacteria, and Actinobacteria phyla accounted for 98% of all of the sequences, with Helicobacter, Streptococcus, and Prevotella ranking among the 10 most abundant genera. H. pylori infection or PPI treatment did not significantly influence gastric microbial species composition in dyspeptic patients. Principal-coordinate analysis of weighted UniFrac distances in these communities revealed clear but significant separation according to H. pylori status only. However, in PPI-treated patients, Firmicutes, particularly Streptococcaceae, were significantly increased in relative abundance compared to those in untreated patients. Consistently, Streptococcus was also found to significantly increase in relation to PPI treatment, and this increase seemed to occur independently of H. pylori infection. Our results suggest that Streptococcus may be a key indicator of PPI-induced gastric microbial composition changes in dyspeptic patients. Whether the gastric microbiota alteration contributes to dyspepsia needs further investigation.
  
  
  
  Although PPIs have become a popular treatment choice, a growing number of dyspeptic patients may be treated unnecessarily. We found that patients treated with omeprazole showed gastric microbial communities that were different from those of untreated patients. These differences regarded the abundances of specific taxa. By understanding the relationships between PPIs and members of the gastric microbiota, it will be possible to envisage new strategies for better managing patients with dyspepsia.
authors: Institute of Microbiology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors: Francesco
authors: F
authors: Paroni Sterbini
authors: Institute of Microbiology, Università Cattolica del Sacro Cuore, Rome, Italy Biomedical Cybernetics Group, Biotechnology Center (BIOTEC), Technische Universität Dresden, Dresden, Germany Paul Langerhans Institute Dresden (PLID), Technische Universität Dresden, Dresden, Germany German Center for Diabetes Research (DZD), Neuherberg, Germany.
authors: Alessandra
authors: A
authors: Palladini
authors: Institute of Microbiology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors: Luca
authors: L
authors: Masucci
authors: Biomedical Cybernetics Group, Biotechnology Center (BIOTEC), Technische Universität Dresden, Dresden, Germany.
authors: Carlo Vittorio
authors: CV
authors: Cannistraci
authors: Institute of Public Health (Section of Hygiene), Università Cattolica del Sacro Cuore, Rome, Italy.
authors: Roberta
authors: R
authors: Pastorino
authors: Internal Medicine and Gastroenterology Unit, Università Cattolica del Sacro Cuore, Rome, Italy.
authors: Gianluca
authors: G
authors: Ianiro
authors: Institute of Microbiology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors: Francesca
authors: F
authors: Bugli
authors: Institute of Microbiology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors: Cecilia
authors: C
authors: Martini
authors: Institute of Public Health (Section of Hygiene), Università Cattolica del Sacro Cuore, Rome, Italy.
authors: Walter
authors: W
authors: Ricciardi
authors: Internal Medicine and Gastroenterology Unit, Università Cattolica del Sacro Cuore, Rome, Italy.
authors: Antonio
authors: A
authors: Gasbarrini
authors: Institute of Microbiology, Università Cattolica del Sacro Cuore, Rome, Italy maurizio.sanguinetti@unicatt.it.
authors: Maurizio
authors: M
authors: Sanguinetti
authors: Internal Medicine and Gastroenterology Unit, Università Cattolica del Sacro Cuore, Rome, Italy.
authors: Giovanni
authors: G
authors: Cammarota
authors: Institute of Public Health (Section of Hygiene), Università Cattolica del Sacro Cuore, Rome, Italy.
authors: Brunella
authors: B
authors: Posteraro
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001419:Bacteria / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D041963:Bacteroidetes / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D004415:Dyspepsia / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D000068536:Bacillota / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D005753:Gastric Mucosa / Q000187:drug effects / Q000382:microbiology*; D000069196:Gastrointestinal Microbiome / Q000187:drug effects* / Q000235:genetics; D020459:Genes, rRNA; D016481:Helicobacter Infections / Q000188:drug therapy / Q000382:microbiology*; D016480:Helicobacter pylori / Q000187:drug effects; D059014:High-Throughput Nucleotide Sequencing; D006801:Humans; D008875:Middle Aged; D009853:Omeprazole / Q000627:therapeutic use; D020560:Proteobacteria / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D054328:Proton Pump Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D013291:Streptococcus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors; D012336:RNA, Ribosomal, 16S; D009853:Omeprazole