HP根除治疗对儿童肠道菌群结构的影响

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Abstract Objective To explore the effect of eradication therapy of Helicobacter pylori (HP) on the structure and interaction of intestinal flora in children. Methods This cross-sectional study was conducted in our hospital from September 2021 to July 2022. Twenty-two children with Helicobacter pylori infection who received bismuth-containing quadruple therapy (BQT) were selected as BQT group, and 23 asymptomatic children who passed ¹³C urea breath test were recruited as control group. Fecal samples were collected at 0, 2, 6 and 26 weeks. The composition of intestinal bacteria in two groups of children was analyzed and compared by sequencing based on 16S rRNA gene. Results At baseline, there was no significant difference in α diversity (observed species, Chao 1 and Shannon index) and β diversity between BQT group and control group. Compared with the baseline level, the α diversity (species richness, Chao 1 and Shannon index) of patients in BQT group decreased significantly at the second week after eradication, and returned to the baseline level at the 26th week after eradication. PCoA analysis showed that compared with the baseline, there was a significant difference in fecal microbial community structure in BQT group (r=0.998, P=0.001) at the second week, and it was recovered at the sixth week (r=0.051, P=0.12) and the 26th week (r=0.091, P=0.97). Compared with the baseline level, the relative abundance of Firmicutes [（48.23%±15.89%） vs（22.05%±11.88%）, P<0.001] and Bacteroides [（42.99%±15.19%）vs（1.47%±2.49%）, P<0.001] in BQT group decreased significantly at the second week after eradication, while the relative abundance of Proteobacteria increased significantly [（3.13%±3.24%） vs（74.61%±12.28%）, P<0.001]. Compared with the baseline, the abundance of 55 bacterial genera in BQT group changed significantly. Among them, 11 taxa increased significantly and 44 taxa decreased. In the 6th week, 87.3% (48/55) of the significant changes were restored, and in the 26th week, 94.5% (52/55) of the significant changes were restored. In the second week of BQT group, the relative abundance of several beneficial taxa decreased, including Bacteroides, fecal Escherichia, Koala, Roche, Bifidobacterium and Eubacterium myxoides. The relative abundance of some harmful bacteria groups increased, including Escherichia, Klebsiella, Enterococcus and Streptococcus. Conclusion s BQT can cause transient ecological imbalance of intestinal microflora in children with Helicobacter pylori positive. These changes almost restored to the level before eradication after 26 weeks of treatment.

Key words： children intestinal flora helicobacter pylori bi-containing quadruple therapy

Received: 09 March 2023

PACS:

R725.7

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	SU Dan
	ZHANG Li
	PAN Dongning

Cite this article:

SU Dan,ZHANG Li,PAN Dongning. Effect of HP eradication therapy on the structure of intestinal flora in children[J]. HuNan ShiFan DaXue XueBao(YiXueBan), 2024, 21(2): 73-77.

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http://yxb.hunnu.edu.cn/EN/ OR http://yxb.hunnu.edu.cn/EN/Y2024/V21/I2/73

[1] 朱蝶, 王小蕾, 戴芸, 等. 幽门螺杆菌感染和根除治疗对小肠细菌过度生长的影响[J]. 中华医学杂志, 2022, 102(42) : 3382-3387.
[2] 洪佳莉, 王忠敏, 金雪峰, 等. 幽门螺杆菌根除疗法对患儿肠道的影响[J]. 中国妇幼健康研究, 2021, 32(5) : 716-719.
[3] 周颖, 王玉环, 芦军萍, 等. 上海市单中心儿童幽门螺杆菌不同治疗方案根除率及其耐药率的横断面调查[J]. 中国循证儿科杂志, 2019, 14(2) : 81-86.
[4] KAKIUCHI T, YAMAMOTO K, IMAMURA I, et al.Gut microbiota changes related to Helicobacter pylori eradication with vonoprazan containing triple therapy among adolescents: a prospective multicenter study[J]. Sci Rep, 2021, 11(1) : 755.
[5] LIU C, WANG Y, SHI J, et al.The status and progress of first-line treatment against Helicobacter pylori infection: a review[J]. Therap Adv Gastroenterol, 2021, 14: 1756284821989177.
[6] 周羽翙, 郑欣晔, 叶梦思, 等. 益生菌辅助含铋剂四联疗法根除幽门螺杆菌的临床研究[J]. 中国现代医学杂志, 2021, 31(1) : 68-73.
[7] HUNG K T, YANG S C, WU C K, et al.Eradication Rates for Esomeprazole and Lansoprazole-Based 7-Day Non-Bismuth Concomitant Quadruple Therapy for First-Line Anti-Helicobacter pylori Treatment in Real World Clinical Practice[J]. Infect Drug Resist, 2021, 14: 1239-1246.
[8] KIM Y I, LEE J Y, KIM C G, et al.Ten-day bismuth-containing quadruple therapy versus 7-day proton pump inhibitor-clarithromycin containing triple therapy as first-line empirical therapy for the Helicobacter pylori infection in Korea: a randomized open-label trial[J]. BMC Gastroenterol, 2021, 21(1) : 95.
[9] GUO Y, ZHANG Y, GERHARD M, et al.Effect of Helicobacter pylori on gastrointestinal microbiota: a population-based study in Linqu, a high-risk area of gastric cancer[J]. Gut, 2020, 69(9) : 1598-1607.
[10] CORNEJO-PAREJA I, MARTÍN-NÚÑEZ G M, ROCA-RODRÍGUEZ M M, et al. H. pylori eradication treatment alters gut microbiota and GLP-1 secretion in humans[J]. J Clin Med, 2019, 8(4) : 451.
[11] LAPIDOT Y, RESHEF L, COHEN D, et al.Helicobacter pylori and the intestinal microbiome among healthy school-age children[J]. Helicobacter, 2021, 26(6) : e12854.
[12] LIU K, ZHANG Y, LI Q, et al.Ethnic differences shape the alpha but not beta diversity of gut microbiota from school children in the absence of environmental differences[J]. Microorganisms, 2020, 8(2) : 254.
[13] ALTOBELLI A, BAUER M, VELEZ K, et al.Helicobacter pylori VacA targets myeloid cells in the gastric lamina propria to promote peripherally induced regulatory T-cell differentiation and persistent infection[J]. MBio, 2019, 10(2) : e00261-19.
[14] MAIOLI T U, BORRAS-NOGUES E, TORRES L, et al.Possible benefits of Faecalibacterium prausnitzii for obesity-associated gut disorders[J]. Front Pharmacol, 2021, 12: 740636.
[15] SITKIN S, LAZEBNIK L, AVALUEVA E, et al.Gastrointestinal microbiome and Helicobacter pylori: Eradicate, leave it as it is, or take a personalized benefit-risk approach?[J]. World J Gastroenterol, 2022, 28(7) : 766.
[16] CHEN M X, WANG S Y, KUO C H, et al.Metabolome analysis for investigating host-gut microbiota interactions[J]. J Formos Med Assoc, 2019, 118: S10-S22.
[17] LOBIONDA S, SITTIPO P, KWON H Y, et al.The role of gut microbiota in intestinal inflammation with respect to diet and extrinsic stressors[J]. Microorganisms, 2019, 7(8) : 271.
[18] 杨祎, 何颖华, 贾菲, 等. 双歧杆菌三联活菌胶囊联合FOLFOX方案用于结直肠癌术后对肠道微生态及抗肿瘤免疫应答的影响[J]. 湖南师范大学学报 (医学版) , 2022, 19(1) : 95-98.