Division of Gastroenterology, Department of Pediatrics, Ramathibodi Hospital, Mahidol University School of Medicine, Thailand.
Research Center, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.
Turk J Gastroenterol. 2021 Jan;32(1):70-75. doi: 10.5152/tjg.2020.20245.
BACKGROUND/AIMS: Prolonged acid suppression from proton pump inhibitor (PPI) has been shown to cause gut microbiota alteration which may increase risk of various infections in adults. We aimed to characterize gut microbiota profiles in children after a short-term use of PPI.
Children aged 1-18 years who underwent PPI therapy were included during April-December 2017. We excluded children who previously used antibiotics or acid suppressants, had a history of acute gastroenteritis or specific food avoidance one month prior to the enrolment. The stool samples before and after the PPI use were collected for gut microbiota composition. The 16S ribosomal RNA gene sequencing was performed by using Illumina MiSeq. The differences in gut microbiota profile after the use of PPI were compared to pre-PPI period.
We completed stool collection in 20 children (median age of 5.8 years and 60% were female). No significant changes in the overall number of species-level taxonomy categories or predominant bacteria phylum (Bacteroidetes) were noted. We found a trend increase in the proportion of phylum Firmicutes among children living in the metropolitan/suburban area (P=.07) and among males (P=.11). In four children with infection-related adverse effects, we noted a non-significant increase in the proportion of phylum Firmicutes after the PPI use (from 35 to 52%, P = .14).
Even the total number and predominant gut microbiota did not significantly change after a four- to eight-week course of PPI therapy; we found a trend of increased proportion of phylum Firmicutes in certain groups of children.
背景/目的：质子泵抑制剂 (PPI) 的长期抑酸作用已被证明会导致肠道微生物群的改变，这可能会增加成年人发生各种感染的风险。我们旨在描述儿童短期使用 PPI 后肠道微生物群的特征。
2017 年 4 月至 12 月期间，纳入了接受 PPI 治疗的 1-18 岁儿童。我们排除了先前使用过抗生素或酸抑制剂、在入组前一个月有急性胃肠炎或特定食物回避史的儿童。在使用 PPI 前后收集粪便样本以检测肠道微生物群组成。采用 Illumina MiSeq 进行 16S 核糖体 RNA 基因测序。将 PPI 使用后的肠道微生物群特征与 PPI 使用前进行比较。
我们完成了 20 名儿童的粪便收集（中位年龄为 5.8 岁，60%为女性）。未观察到物种水平分类群或主要细菌门（拟杆菌门）的总数有显著变化。我们发现，在大都市/郊区居住的儿童（P=.07）和男性（P=.11）中，厚壁菌门的比例呈上升趋势。在 4 名发生与感染相关的不良事件的儿童中，我们注意到 PPI 使用后厚壁菌门的比例虽无显著增加（从 35%增至 52%，P =.14）。
即使在接受四至八周 PPI 治疗后，肠道微生物群的总数和主要菌群也没有显著变化；我们发现某些组别的儿童厚壁菌门的比例呈增加趋势。
