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. 2021 Oct 13;13(1):60.
doi: 10.1186/s13099-021-00460-2.

Impact of Helicobacter pylori eradication on the gastric microbiome

Li-Qi Mao #  1   2 , Yan-Lin Zhou #  1 , Shuang-Shuang Wang  1   3 , Lin Chen  1 , Yue Hu  1 , Lei-Min Yu  1   4 , Jing-Ming Xu  1 , Bin Lyu  5
Affiliations

Impact of Helicobacter pylori eradication on the gastric microbiome

Li-Qi Mao et al. Gut Pathog. .

Abstract

Background: Helicobacter pylori (Hp) eradication has been used for many years. Yet, the impact of this eradication on the normal gastric microflora is not well understood. In this study, we explored the effect of eradication on the stomach microbial community and its recovery after successful Hp eradication.

Methods: Among the 89 included patients, 23, 17, 40, and 9 were included in the Hp-negative, Hp-positive, successful eradication, and failed eradication groups, respectively. Four subgroups were further determined according to disease status (Hp-negative chronic gastritis [N-CG], Hp-negative atrophic gastritis [N-AG], successful-eradication chronic gastritis [SE-CG], and atrophic gastritis with successful eradication [SE-AG]). During the endoscopic examination, one piece of gastric mucosa tissue was obtained from the lesser curvature side of the gastric antrum and gastric corpus, respectively. In addition, 16S rDNA gene sequencing was used to analyze the gastric mucosal microbiome.

Results: In the Hp-negative group, the gastric microbiota was dominated by five phyla: Firmicutes, Proteobacteria, Actinobacteria, Bacteroidetes, and Fusobacteria. After successfully eradicating Hp, the bacterial flora in the stomach recovered to a considerable extent. In the failed eradication group, the flora was similar to the flora in Hp-positive subjects based on the alpha and beta diversities. Among the groups, Curvibacter and Acinetobacter were enriched in the presence of Hp (i.e., failed eradication and Hp-positive groups), suggesting that these two genera could be used as biomarkers in the symbiotic flora in the presence of Hp. SE-CG was characterized by an increase in Firmicutes taxa and a decrease in Proteobacteria taxa compared with N-CG. SE-AG was characterized by a decrease in Firmicutes relative to N-AG. Finally, no differences were found in the pairwise comparisons of nitrate and nitrite reductase functions of the microflora among the four subgroups.

Conclusions: After Hp infection, the diversity and relative abundance of gastric microflora were significantly decreased. Yet, gastric microbiota could be partially restored to the Hp-negative status after eradication. Still, this effect was incomplete and might contribute to the long-term risks.

Keywords: 16S rDNA gene sequencing; Atrophic gastritis; Eradication therapy; Gastric microflora; Helicobacter pylori.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The Alpha diversity was evaluated and transformed into a box plot. The species diversity and complexity of the samples were analyzed by four indices, including Observed species, Chao1, Shannon index, and Simpson index. A Boxplot in the gastric antrum and corpus mucosa groups. B Boxplot in the four groups: Hp-Negative, Hp-Positive, Successful Eradication, and Failed Eradication. C Boxplot in the four subgroups: N-CG, N-AG, SE-CG, and SE-AG. Statistical significance was determined by the Wilcoxon test
Fig. 2
Fig. 2
Principal coordinate analysis (PCoA) plots in which the samples were colored based on A paired sample location and clinical grouping: B Hp-Negative vs. Successful-eradication; C Hp-Positive vs. Failed-eradication; D all four groups; E four subgroups. ANOSIM, analysis of similarity
Fig. 3
Fig. 3
The Z-score was obtained by subtracting the average abundance and dividing it by the standard deviation of all samples. By converting the Z score into a heat map, the results of significant features (LDA score > 3.5 and adjusted P < 0.1) were displayed, including Hp (A) and excluding Hp (B) related reads, P < 0.01 and P < 0.05 are marked in red and green, respectively
Fig. 4
Fig. 4
A Top 10 relative abundance and Bray–Curtis distance of the four groups (P, N, SE, and FE) were displayed at the phylum and genus levels. Similar bacterial composition was observed between N and SE and between P and FE. Bray–Curtis distances were used to determine the similarity of groups based on bacteria composition. B The average relative abundance of the two main phyla under different references in groups N and SE and subgroups were compared, and the significance was calculated by the Mann–Whitney test (P < 0.05). The average relative abundance was also shown by the Circos plot
Fig. 5
Fig. 5
Association of specific microbiota taxa with the group of chronic gastritis and gastric carcinoma by LEfSe (LDA score > 3.5, P < 0.05). We presented the results of the analysis between N and SE (A), N-CG and SE-CG (B), and N-AG and SE-AG (C)
Fig. 6
Fig. 6
Associations of microbiota with predicted KEGG functions evaluated by Spearman correlation coefficients between 33 genera and differential KEGG pathways in N-CG versus N-AG (A), and between 7 genera and differential KEGG pathways in N-CG versus SE-CG (B). KEGG, Kyoto encyclopedia of genes and genomes
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