Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 7, 2021; 27(25): 3913-3924
Published online Jul 7, 2021. doi: 10.3748/wjg.v27.i25.3913
Effect of gastric microbiota on quadruple Helicobacter pylori eradication therapy containing bismuth
Zhan-Yue Niu, Si-Zhu Li, Yan-Yan Shi, Yan Xue
Zhan-Yue Niu, Si-Zhu Li, Yan Xue, Department of Gastroenterology, Peking University Third Hospital, Beijing 100191, China
Yan-Yan Shi, Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, China
Author contributions: Xue Y was the guarantor and designed the study; Niu ZY, Li SZ and Shi YY participated in the acquisition, analysis, and interpretation of the data and drafted the initial manuscript; Xue Y revised the article critically for important intellectual content; all authors have read and approved the final manuscript.
Supported by The Key Projects of Peking University Third Hospital, No. BYSY2017026.
Institutional review board statement: The study was reviewed and approved by the Peking University Third Hospital Medical Science Research Ethics Committee Institutional Review Board (Approval No. M2017389).
Informed consent statement: Informed written consent was obtained from the patient.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan Xue, MD, Doctor, Department of Gastroenterology, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing 100191, China. xueyanby@163.com
Received: February 9, 2021
Peer-review started: February 9, 2021
First decision: March 28, 2021
Revised: April 10, 2021
Accepted: May 27, 2021
Article in press: May 27, 2021
Published online: July 7, 2021
ARTICLE HIGHLIGHTS
Research background

There are complex interactions between Helicobacter pylori (H. pylori) and other microbial communities in the gastric microecological environment. Yet, it remains unclear whether the interactions affect the eradication of H. pylori.

Research motivation

The motivation was to explore the interaction between gastric microbiota and H. pylori and to determine the influence of gastric microbiota on the eradication of H. pylori.

Research objectives

To investigate the characteristics of the gastric mucosa microbiota with H. pylori infection and the influence on H. pylori eradication treatment. This may help improve the eradication rate of H. pylori in the future.

Research methods

Patients with H. pylori infection underwent gastroscopy and received treatment. Propensity matching analysis was conducted, including the number of patients who did not respond to treatment. The gastric microbiota was assayed by high-throughput sequencing and subsequent analysis of alpha diversity, beta diversity, species correlations, and predicted metabolic pathways.

Research results

The main phyla in the two groups were the same in the eight failure group patients who did not respond well to therapy and the 16 success group patients and included Proteobacteria, Bacteroides, Firmicutes, Actinomycetes, and Fusobacteria. The high rate of H. pylori eradication was associated with Rhodococcus, Lactobacillus, and Sphingomonas. H. pylori was negatively correlated with other bacterial genera, and more bacterial genera were directly related to H. pylori in the success group.

Research conclusions

The effectiveness of quadruple H. pylori eradication therapy containing bismuth depended on the gastric microbiota. The high rate of H. pylori eradication was associated with Rhodococcus, Lactobacillus, and Sphingomonas.

Research perspectives

This study laid a foundation for further research on the mechanism of the influence of the gastric microbiota on H. pylori eradication, which will help to improve the eradication rate of H. pylori in the future.