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Gut Microbiota Composition Before and After Use of Proton Pump Inhibitors
Mariko Hojo1, Takashi Asahara2,3, Akihito Nagahara4
1Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan. mhojo@juntendo.ac.jp.
Background:
Recently, problems associated with proton pump inhibitor (PPI) use have begun to surface. PPIs influence the gut microbiota; therefore, PPI use may increase the risk of enteric infections and cause bacterial translocation. In this study, we investigated fecal microbiota composition, fecal organic acid concentrations and pH, and gut bacteria in the blood of the same patients before and after PPI use.
Methods:
Twenty patients with reflux esophagitis based on endoscopic examination received 8 weeks of treatment with PPIs. To analyze fecal microbiota composition and gut bacteria in blood and organic acid concentrations, 16S and 23S rRNA-targeted quantitative RT-PCR and high-performance liquid chromatography were conducted.
Results:
Lactobacillus species were significantly increased at both 4 and 8 weeks after PPI treatment compared with bacterial counts before treatment (P = 0.011 and P = 0.002, respectively). Among Lactobacillus spp., counts of the L. gasseri subgroup, L. fermentum, the L. reuteri subgroup, and the L. ruminis subgroup were significantly increased at 4 and 8 weeks after treatment compared with counts before treatment. Streptococcus species were also significantly increased at 4 and 8 weeks after PPI treatment compared with counts before treatment (P < 0.01 and P < 0.001, respectively). There was no significant difference in the total organic acid concentrations before and after PPI treatment. Detection rates of bacteria in blood before and after PPI treatment were 22 and 28%, respectively, with no significant differences.
Conclusions:
Our quantitative RT-PCR results showed that gut dysbiosis was caused by PPI use, corroborating previous results obtained by metagenomic analysis.
Insights
Proton pump inhibitor (PPI) use significantly altered gut bacteria, increasing Lactobacillus and Streptococcus species. This study investigated PPIs' impact on gut microbiota composition and bacterial translocation.
Area of Science:
- Gastroenterology
- Microbiology
- Pharmacology
Background:
- Proton pump inhibitors (PPIs) are increasingly linked to adverse effects.
- PPIs can alter gut microbiota, potentially increasing infection risk and bacterial translocation.
- This study examines the impact of PPIs on gut microbiota and bacterial translocation.
Purpose of the Study:
- To investigate changes in fecal microbiota composition and gut bacteria in blood following PPI treatment.
- To analyze fecal organic acid concentrations and pH before and after PPI use.
Main Methods:
- Twenty patients with reflux esophagitis received 8 weeks of PPI treatment.
- Quantitative RT-PCR targeting 16S and 23S rRNA was used to analyze fecal microbiota and bacteria in blood.
- High-performance liquid chromatography was employed to measure organic acid concentrations.
Main Results:
- Lactobacillus and Streptococcus species significantly increased after PPI treatment.
- Specific Lactobacillus subgroups (L. gasseri, L. fermentum, L. reuteri, L. ruminis) showed marked increases.
- No significant differences were observed in total organic acid concentrations or bacterial detection rates in blood.
Conclusions:
- PPI use leads to gut dysbiosis, characterized by increased Lactobacillus and Streptococcus species.
- Findings corroborate previous research on PPI-induced gut microbiota alterations.
- PPIs significantly impact gut microbial composition, potentially affecting gut health.
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