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Influence of Proton-Pump Inhibitors on the Luminal Microbiota in the Gastrointestinal Tract.

Tsuda A, Suda W, Morita H, Takanashi K, Takagi A, Koga Y, Hattori M - Clin Transl Gastroenterol (2015)

Bottom Line: The objective of this study was to investigate comparatively the influence of proton-pump inhibitors (PPI) administration on three bacterial communities in the oral cavity, stomach, and colon along the alimentary tract.In the comparison between PPI-users and PPI-nonusers, a bacterial cell number increase of ~1,000 times was found in the GF of PPI-users using culturing methods, whereas the bacterial number and composition were nearly identical between the two groups using quantitative PCR and a similarity search based on 16S profiling.The biological significance of the increase in beta diversity by PPI administration remains unclear.

View Article: PubMed Central - PubMed

Affiliation: 1] Laboratory for Infectious Diseases, Tokai University School of Medicine, Isehara, Japan [2] Department of General Medicine, Tokai University School of Medicine, Isehara, Japan.

ABSTRACT

Objectives: The objective of this study was to investigate comparatively the influence of proton-pump inhibitors (PPI) administration on three bacterial communities in the oral cavity, stomach, and colon along the alimentary tract.

Methods: Forty-five subjects including 18 patients taking PPI were enrolled. Stimulated saliva, gastric fluid (GF), and feces were obtained from each subject for the microbiota analysis through bacterial 16S rRNA gene profiling using the pyrosequencing method.

Results: The species richness (alpha diversity) was similar among these three microbiota, whereas the interindividual diversity (beta diversity) was much higher in the fecal microbiota compared with that in the others. The UniFrac analysis indicated that the salivary and GF microbiota were similar to one another; however, both differed greatly from the fecal microbiota in the overall bacterial community structure. In the comparison between PPI-users and PPI-nonusers, a bacterial cell number increase of ~1,000 times was found in the GF of PPI-users using culturing methods, whereas the bacterial number and composition were nearly identical between the two groups using quantitative PCR and a similarity search based on 16S profiling. The beta diversity significantly increased in both the salivary and GF microbiota of PPI-users compared with PPI-nonusers.

Conclusions: These results suggest that the GF microbiota has recently moved from the saliva. Bacterial overgrowth in the GF by PPI administration may be due to a lack of killing rather than proliferation of the bacteria in the acid-suppressed stomach. The biological significance of the increase in beta diversity by PPI administration remains unclear.

No MeSH data available.


Related in: MedlinePlus

The relation between the pH value and the bacterial count using a culturing method in gastric fluid (GF). The pH value (horizontal axis) and the bacterial count (vertical axis) according to a culturing method in the GF of each subject were plotted by a circle to evaluate Spearman's correlation coefficient. Open and filled circles represent proton-pump inhibitor (PPI)-nonusers and PPI-users, respectively.
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fig6: The relation between the pH value and the bacterial count using a culturing method in gastric fluid (GF). The pH value (horizontal axis) and the bacterial count (vertical axis) according to a culturing method in the GF of each subject were plotted by a circle to evaluate Spearman's correlation coefficient. Open and filled circles represent proton-pump inhibitor (PPI)-nonusers and PPI-users, respectively.

Mentions: Table 1 summarizes the demographic and clinical data of the 45 subjects in total, which included 18 PPI-users and 27 PPI-nonusers. In the comparison between those two groups, the mean age of the subjects was significantly higher in PPI-users compared with that in PPI-nonusers. The pH value of the saliva was moderately higher in the former compared with that in the latter. In the GF, the pH value was significantly higher in PPI-users than in PPI-nonusers, which indicated that gastric acid secretion was significantly inhibited in PPI-users. The log bacterial count obtained using culturing methods was also significantly higher in PPI-users compared with that in PPI-nonusers. A significant correlation was observed between the pH value and the cultured bacterial count in all the GF samples (Figure 6), thus indicating that the increase in the bacterial count in PPI-users could be due to low gastric acidity. On the other hand, the average log copy number of the bacterial cells in the GF (/ml) measured by qPCR was nearly the same between PPI-users (8.0±0.8) and PPI-nonusers (8.1±0.8), although qPCR cannot distinguish between live and dead bacteria (Supplementary Figure S1). Therefore, the discrepancy in the estimated bacterial quantity in the GF microbiota of PPI-nonusers using culturing and qPCR methods (mean, 4.4 vs. 8.1, respectively) may be explained by the inability of culturing method to detect dead or metabolically inactive bacteria in highly acidic GF.


Influence of Proton-Pump Inhibitors on the Luminal Microbiota in the Gastrointestinal Tract.

Tsuda A, Suda W, Morita H, Takanashi K, Takagi A, Koga Y, Hattori M - Clin Transl Gastroenterol (2015)

The relation between the pH value and the bacterial count using a culturing method in gastric fluid (GF). The pH value (horizontal axis) and the bacterial count (vertical axis) according to a culturing method in the GF of each subject were plotted by a circle to evaluate Spearman's correlation coefficient. Open and filled circles represent proton-pump inhibitor (PPI)-nonusers and PPI-users, respectively.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4816248&req=5

fig6: The relation between the pH value and the bacterial count using a culturing method in gastric fluid (GF). The pH value (horizontal axis) and the bacterial count (vertical axis) according to a culturing method in the GF of each subject were plotted by a circle to evaluate Spearman's correlation coefficient. Open and filled circles represent proton-pump inhibitor (PPI)-nonusers and PPI-users, respectively.
Mentions: Table 1 summarizes the demographic and clinical data of the 45 subjects in total, which included 18 PPI-users and 27 PPI-nonusers. In the comparison between those two groups, the mean age of the subjects was significantly higher in PPI-users compared with that in PPI-nonusers. The pH value of the saliva was moderately higher in the former compared with that in the latter. In the GF, the pH value was significantly higher in PPI-users than in PPI-nonusers, which indicated that gastric acid secretion was significantly inhibited in PPI-users. The log bacterial count obtained using culturing methods was also significantly higher in PPI-users compared with that in PPI-nonusers. A significant correlation was observed between the pH value and the cultured bacterial count in all the GF samples (Figure 6), thus indicating that the increase in the bacterial count in PPI-users could be due to low gastric acidity. On the other hand, the average log copy number of the bacterial cells in the GF (/ml) measured by qPCR was nearly the same between PPI-users (8.0±0.8) and PPI-nonusers (8.1±0.8), although qPCR cannot distinguish between live and dead bacteria (Supplementary Figure S1). Therefore, the discrepancy in the estimated bacterial quantity in the GF microbiota of PPI-nonusers using culturing and qPCR methods (mean, 4.4 vs. 8.1, respectively) may be explained by the inability of culturing method to detect dead or metabolically inactive bacteria in highly acidic GF.

Bottom Line: The objective of this study was to investigate comparatively the influence of proton-pump inhibitors (PPI) administration on three bacterial communities in the oral cavity, stomach, and colon along the alimentary tract.In the comparison between PPI-users and PPI-nonusers, a bacterial cell number increase of ~1,000 times was found in the GF of PPI-users using culturing methods, whereas the bacterial number and composition were nearly identical between the two groups using quantitative PCR and a similarity search based on 16S profiling.The biological significance of the increase in beta diversity by PPI administration remains unclear.

View Article: PubMed Central - PubMed

Affiliation: 1] Laboratory for Infectious Diseases, Tokai University School of Medicine, Isehara, Japan [2] Department of General Medicine, Tokai University School of Medicine, Isehara, Japan.

ABSTRACT

Objectives: The objective of this study was to investigate comparatively the influence of proton-pump inhibitors (PPI) administration on three bacterial communities in the oral cavity, stomach, and colon along the alimentary tract.

Methods: Forty-five subjects including 18 patients taking PPI were enrolled. Stimulated saliva, gastric fluid (GF), and feces were obtained from each subject for the microbiota analysis through bacterial 16S rRNA gene profiling using the pyrosequencing method.

Results: The species richness (alpha diversity) was similar among these three microbiota, whereas the interindividual diversity (beta diversity) was much higher in the fecal microbiota compared with that in the others. The UniFrac analysis indicated that the salivary and GF microbiota were similar to one another; however, both differed greatly from the fecal microbiota in the overall bacterial community structure. In the comparison between PPI-users and PPI-nonusers, a bacterial cell number increase of ~1,000 times was found in the GF of PPI-users using culturing methods, whereas the bacterial number and composition were nearly identical between the two groups using quantitative PCR and a similarity search based on 16S profiling. The beta diversity significantly increased in both the salivary and GF microbiota of PPI-users compared with PPI-nonusers.

Conclusions: These results suggest that the GF microbiota has recently moved from the saliva. Bacterial overgrowth in the GF by PPI administration may be due to a lack of killing rather than proliferation of the bacteria in the acid-suppressed stomach. The biological significance of the increase in beta diversity by PPI administration remains unclear.

No MeSH data available.


Related in: MedlinePlus