Wellhöner Freya, Döscher Nico, Tergast Tammo Lambert, Vital Marius, Plumeier Iris, Kahl Silke, Potthoff Andrej, Manns Michael Peter, Maasoumy Benjamin, Wedemeyer Heiner, Cornberg Markus, Pieper Dietmar Helmut, Heidrich Benjamin
Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School , Hannover , Germany.
Helmholtz Center for Infection Research, Microbial Interactions and Processes Research Group , Braunschweig , Germany.
Scand J Gastroenterol. 2019 Aug;54(8):1033-1041. doi: 10.1080/00365521.2019.1647280. Epub 2019 Jul 30.
Proton pump inhibitors (PPI), a class of drugs commonly used, are known to be associated with changes in the intestinal microbiota. Published studies were done in heterogeneous cohorts which could hamper conclusions drawn as effects of diseases were not taken into consideration. We aimed to elucidate differences in the intestinal microbiota being associated to the use of PPI in a cohort study of patients with chronic hepatitis C. The 16S rDNA gene was analyzed in stool samples of patients with and without PPI use. Patients with concomitant medication influencing the microbiota were excluded. Results were compared with the clinical course of hepatitis C patients with decompensated liver cirrhosis. No differences in alpha diversity could be observed, while the microbial community structure differed significantly, especially in patients with liver cirrhosis. The relative abundance of ., . and . was significantly increased in patients with PPI use irrespectively of the stage of liver disease. Finally, in patients with decompensated liver cirrhosis due to chronic HCV infection only in these using PPI bacterial phylotypes were isolated. PPI use was associated with significant alterations in the microbial community in patients with chronic hepatitis C, which were even pronounced in patients with liver cirrhosis. In patients with decompensated liver cirrhosis due to chronic HCV infection, the use of PPI may promote infections either directly or indirectly through changes in the microbial community structure. Future studies should further investigate long-term impact on the microbiota and the clinical outcome.
质子泵抑制剂（PPI）是一类常用药物，已知其与肠道微生物群的变化有关。已发表的研究是在异质性队列中进行的，由于未考虑疾病的影响，可能会妨碍得出的结论。我们旨在通过一项慢性丙型肝炎患者队列研究，阐明与使用PPI相关的肠道微生物群差异。对使用和未使用PPI的患者粪便样本中的16S rDNA基因进行分析。排除同时使用影响微生物群药物的患者。将结果与失代偿期肝硬化丙型肝炎患者的临床病程进行比较。未观察到α多样性的差异，而微生物群落结构存在显著差异，尤其是在肝硬化患者中。无论肝病处于何阶段，使用PPI的患者中，[此处原文缺失部分微生物名称]的相对丰度均显著增加。最后，在因慢性丙型肝炎病毒感染导致失代偿期肝硬化的患者中，仅在使用PPI的患者中分离出细菌系统发育型。使用PPI与慢性丙型肝炎患者的微生物群落显著改变有关，在肝硬化患者中更为明显。在因慢性丙型肝炎病毒感染导致失代偿期肝硬化的患者中，使用PPI可能通过微生物群落结构的变化直接或间接促进感染。未来的研究应进一步调查对微生物群和临床结局的长期影响。
