Gastric microbes associated with gastric inflammation, atrophy and intestinal metaplasia 1 year after Helicobacter pylori eradication.

Abstract

OBJECTIVE:

Helicobacter pylori is associated with gastric inflammation, precancerous gastric atrophy (GA) and intestinal metaplasia (IM). We aimed to identify microbes that are associated with progressive inflammation, GA and IM 1 year after H. pylori eradication.

DESIGN:

A total of 587 H. pylori-positive patients were randomised to receive H. pylori eradication therapy (295 patients) or placebo (292 patients). Bacterial taxonomy was analysed on 404 gastric biopsy samples comprising 102 pairs before and after 1 year H. pylori eradication and 100 pairs before and after 1 year placebo by 16S rRNA sequencing.

RESULTS:

Analysis of microbial sequences confirmed the eradication of H. pylori in treated group after 1 year. Principal component analysis revealed distinct microbial clusters reflected by increase in bacterial diversity (p<0.00001) after H. pylori eradication. While microbial interactions remained largely unchanged after placebo treatment, microbial co-occurrence was less in treated group. Acinetobacter lwoffii, Streptococcus anginosus and Ralstonia were enriched while Roseburia and Sphingomonas were depleted in patients with persistent inflammation 1 year after H. pylori eradication. A distinct cluster of oral bacteria comprising Peptostreptococcus, Streptococcus, Parvimonas, Prevotella, Rothia and Granulicatella were associated with emergence and persistence of GA and IM. Probiotic Faecalibacterium praustznii was depleted in subjects who developed GA following H. pylori eradication. Functional pathways including amino acid metabolism and inositol phosphate metabolism were enriched while folate biosynthesis and NOD-like receptor signalling decreased in atrophy/IM-associated gastric microbiota.

CONCLUSION:

This study identified that gastric microbes contribute to the progression of gastric carcinogenesis after H. pylori eradication.

• Authors: Joseph J Y Sung, Olabisi Oluwabukola Coker, Eagle Chu, Chun Ho Szeto, Simson Tsz Yat Luk, Harry Cheuk Hay Lau, Jun Yu
• Journal: Gut (Gut) Vol. 69 Issue 9 Pg. 1572-1580 (09 2020) ISSN: 1468-3288 [Electronic] England
• PMID: 31974133 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Topics

• Bacteria (classification, genetics, isolation & purification, pathogenicity)
• Biopsy (methods, statistics & numerical data)
• Carcinogenesis
• Disease Eradication (methods, statistics & numerical data)
• Disease Progression
• Female
• Gastritis, Atrophic (microbiology, pathology)
• Helicobacter Infections (diagnosis, drug therapy)
• Helicobacter pylori (drug effects, isolation & purification)
• Humans
• Male
• Metaplasia (microbiology, pathology)
• Microbial Interactions (drug effects)
• Middle Aged
• Sequence Analysis, RNA (methods)
• Stomach (microbiology, pathology)