High-dose dual therapy for Helicobacter pylori eradication inducing less impact on the gut microbiota.

IF 4.3 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gut Pathogens Pub Date : 2025-01-30 DOI:10.1186/s13099-025-00682-8

Jia-Lun Guan, Ting-Ting Xu, Ya Lin, Yan-Shuai Mo, Bi-Yu He, Ying-Ying Han, Ji-Yan Li, Su-Hong Xia, Ya-Ni Zhou, Jia-Zhi Liao, Pei-Yuan Li

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引用次数: 0

Abstract

Background: Helicobacter pylori (H. pylori) eradication regimens may have different effects on the gut microbiota. Few studies have analyzed the safety of high-dose dual therapy (HDDT) from a micro-ecological perspective. This study aimed to compare the impact of H. pylori eradication with HDDT and bismuth quadruple therapy (BQT) on gut microbiota.

Patients and methods: H. Pylori-infected treatment-naive patients were recruited and screened from September 2023 to April 2024 and randomly assigned to the HDDT group (esomeprazole 20 mg, amoxicillin 750 mg, qid, 14 days) or BQT group (esomeprazole 20 mg, amoxicillin 1000 mg, clarithromycin 500 mg, and bismuth potassium citrate 600 mg, bid, 14 days). Fresh stool specimens were collected and stored before treatment and at week 2 and week 8 after treatment. The diversity and composition of the gut microbiota were compared and analyzed in both groups using 16 S rRNA gene sequencing.

Results: Forty-nine H. pylori positive patients were enrolled and randomly assigned to either the HDDT (n = 24) or the BQT group (n = 25) group. Compared with baseline, alpha and beta diversities significantly changed at week 2 after receiving BQT and did not recover fully at week 8. However, in the HDDT group, the diversities at week 2 changed mildly without statistical significance, compared to baseline. Additionally, a greater number of species had alterations in their abundances in the BQT group compared to the HDDT group at week 2. However, the abundances of these species were restored to their previous levels at week 8 in both the HDDT and BQT groups.

Conclusions: Compared to BQT, HDDT exerted less impact on the diversity and composition of the gut microbiota.

Clinical trial registration: ChiCTR2100053268.

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根除幽门螺杆菌的高剂量双重治疗对肠道菌群的影响较小。

背景：幽门螺杆菌（h.p ylori）根除方案可能对肠道微生物群有不同的影响。很少有研究从微生态角度分析高剂量双重治疗（HDDT）的安全性。本研究旨在比较HDDT和铋四联疗法（BQT）根除幽门螺杆菌对肠道微生物群的影响。患者和方法：从2023年9月至2024年4月招募并筛选幽门幽门杆菌感染的初次治疗患者，随机分配到HDDT组（埃索美拉唑20 mg，阿莫西林750 mg， 1次，14天）或BQT组（埃索美拉唑20 mg，阿莫西林1000 mg，克拉霉素500 mg，柠檬酸铋钾600 mg， 1次，14天）。治疗前、治疗后第2周和第8周采集新鲜粪便标本保存。采用16s rRNA基因测序法比较分析两组小鼠肠道菌群的多样性和组成。结果：49例幽门螺杆菌阳性患者入组，随机分为HDDT组（n = 24）和BQT组（n = 25）。与基线相比，α和β多样性在接受BQT治疗后第2周发生显著变化，在第8周未完全恢复。然而，在HDDT组中，与基线相比，第2周的多样性变化轻微，无统计学意义。此外，在第2周，与HDDT组相比，BQT组中有更多物种的丰度发生了变化。然而，在HDDT组和BQT组中，这些物种的丰度在第8周恢复到以前的水平。结论：与BQT相比，HDDT对肠道菌群多样性和组成的影响较小。临床试验注册：ChiCTR2100053268。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gut Pathogens GASTROENTEROLOGY & HEPATOLOGY-MICROBIOLOGY

CiteScore

7.70

自引率

2.40%

发文量

期刊介绍： Gut Pathogens is a fast publishing, inclusive and prominent international journal which recognizes the need for a publishing platform uniquely tailored to reflect the full breadth of research in the biology and medicine of pathogens, commensals and functional microbiota of the gut. The journal publishes basic, clinical and cutting-edge research on all aspects of the above mentioned organisms including probiotic bacteria and yeasts and their products. The scope also covers the related ecology, molecular genetics, physiology and epidemiology of these microbes. The journal actively invites timely reports on the novel aspects of genomics, metagenomics, microbiota profiling and systems biology. Gut Pathogens will also consider, at the discretion of the editors, descriptive studies identifying a new genome sequence of a gut microbe or a series of related microbes (such as those obtained from new hosts, niches, settings, outbreaks and epidemics) and those obtained from single or multiple hosts at one or different time points (chronological evolution).