Department of Gastroenterology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China.
Department of Gastroenterology and Hepatology, The First Medical Center, Chinese PLA General Hospital, Beijing, China.
Front Cell Infect Microbiol. 2023 Aug 17;13:1205348. doi: 10.3389/fcimb.2023.1205348. eCollection 2023.
Gut mycobiota inhabits human gastrointestinal lumen and plays a role in human health and disease. We investigated the influence of proton pump inhibitors (PPIs) on gastric mucosal and fecal mycobiota in patients with gastroesophageal reflux diseases (GERD) by using Internal Transcribed Spacer 1 sequencing. A total of 65 participants were included, consisting of the healthy control (HC) group, GERD patients who did not use PPIs (nt-GERD), and GERD patients who used PPIs, which were further divided into short-term (s-PPI) and long-term PPI user (l-PPI) groups based on the duration of PPI use. The alpha diversity and beta diversity of gastric mucosal mycobiota in GERD patients with PPI use were significantly different from HCs, but there were no differences between s-PPI and l-PPI groups. LEfSe analysis identified at the genus level as a biomarker for the s-PPI group when compared to the nt-GERD group. Meanwhile, , , , , and were more abundant in the l-PPI group than in the nt-GERD group. Furthermore, colonization of in gastric mucosa was significantly increased after PPI treatment. However, there was no significant difference in colonization between patients with endoscopic esophageal mucosal breaks and those without. There were significant differences in the fecal mycobiota composition between HCs and GERD patients regardless whether or not they used PPI. As compared to nt-GERD patient samples, there was a high abundance of , , , , and in the s-PPI group. In addition, there was a significantly higher abundance of , , , , and in the l-PPI group than nt-GERD patients. In conclusion, our study indicates that dysbiosis of mycobiota was presented in GERD patients in both gastric mucosal and fecal mycobiota. PPI treatment may increase the colonization of in the gastric mucosa in GERD patients.
肠道真菌群栖息在人类胃肠道腔中，在人类健康和疾病中发挥作用。我们通过内部转录间隔区 1 测序研究了质子泵抑制剂 (PPIs) 对胃食管反流病 (GERD) 患者胃黏膜和粪便真菌群的影响。共有 65 名参与者，包括健康对照组 (HC)、未使用 PPIs 的 GERD 患者 (nt-GERD) 和使用 PPIs 的 GERD 患者，根据 PPI 使用时间进一步分为短期 (s-PPI) 和长期 PPI 使用者 (l-PPI) 组。与 HCs 相比，使用 PPI 的 GERD 患者的胃黏膜真菌群的 alpha 多样性和 beta 多样性差异显著，但 s-PPI 和 l-PPI 组之间无差异。LEfSe 分析在属水平上确定 为 s-PPI 组与 nt-GERD 组相比的生物标志物。同时，与 nt-GERD 组相比，l-PPI 组中 、 、 、 、 的丰度更高。此外，PPIs 治疗后 定植于胃黏膜的丰度显著增加。然而，内镜食管黏膜破裂患者与无食管黏膜破裂患者之间的 定植无显著差异。无论是否使用 PPI，HC 和 GERD 患者之间的粪便真菌群组成均存在显著差异。与 nt-GERD 患者样本相比，s-PPI 组中 、 、 、 的丰度更高。此外，与 nt-GERD 患者相比，l-PPI 组中 、 、 、 、 的丰度显著更高。总之，本研究表明，GERD 患者的胃黏膜和粪便真菌群均存在菌群失调。PPI 治疗可能会增加 GERD 患者胃黏膜中 的定植。
