Wang Yuxin, Zhou Kai, Zhang Yuexi, Li Cailing, Zhang Yuxin, Ren Xinlu, Mi Changmin, Ma Lingling, Duan Yuqi, Liu Mengqi, Ping Guangjie, Tian Xueli, Song Zhiqiang
Department of Gastroenterology, Peking University Third Hospital, Beijing, China.
Department of Gastroenterology, The Sixth Hospital of Beijing, Beijing, China.
Helicobacter. 2025 May-Jun;30(3):e70047. doi: 10.1111/hel.70047.
Recent studies have found that in addition to directly impacting the gastric microbiome, Helicobacter pylori (H. pylori) infection may cause intestinal microbial dysbiosis. However, most existing studies on the influence of H. pylori infection on the intestinal microbiome used fecal specimens with inconsistent conclusions. Only one limited study on 8 H. pylori-infected patients has previously assessed the impact of H. pylori infection on the microbiome of the entire gastrointestinal tract, finding no significant effect on the bacterial composition of the lower gastrointestinal tract.
This single-center cross-sectional study collected mucosa of the esophagus, stomach, small intestine, and colon, as well as gastric juice and feces from 120 participants of the H. pylori-infected group (HIG) and 30 of the healthy control group (HCG). 16S rRNA sequencing was applied to analyze the bacterial composition and functional pathways, and metagenomics was adopted to assess the composition of viruses, eukaryotes, and archaea in the feces, as well as the antibiotic resistance gene (ARG) and virulence factors of bacteria (VF).
Compared with the HCG, the alpha and beta diversity of bacteria in the mucosa of the whole digestive tract and the gastric juice of the HIG showed significant changes, with increased microbial dysbiosis index and significantly different compositions at the phylum and genus levels. Functional pathway analysis revealed that the metabolic characteristics of the flora changed in the HIG, with site-specific differences. Fecal specimens demonstrated no significant differences in the above indicators between the two groups. In addition, feces-based metagenomic analysis revealed that only eukaryotes had higher diversity in the HIG, whereas viruses and archaea showed no significant changes; the Shannon index of ARG increased; and VF showed no significant change.
This study revealed that H. pylori infection significantly influenced the diversity, composition, and metabolic functional pathway of bacteria in different parts of the digestive tract and the gastric juice. Moreover, fecal microbial composition may not fully represent the mucosal microbial composition of the gastrointestinal tract.
Chinese Clinical Trial Registry: ChiCTR2300073419.
近期研究发现，幽门螺杆菌（H. pylori）感染除了直接影响胃部微生物群外，还可能导致肠道微生物失调。然而，大多数现有关于H. pylori感染对肠道微生物群影响的研究使用粪便样本，结论并不一致。此前仅有一项针对8名H. pylori感染患者的有限研究评估了H. pylori感染对整个胃肠道微生物群的影响，发现对下消化道细菌组成无显著影响。
本单中心横断面研究收集了120名幽门螺杆菌感染组（HIG）参与者和30名健康对照组（HCG）参与者的食管、胃、小肠和结肠黏膜以及胃液和粪便。应用16S rRNA测序分析细菌组成和功能途径，并采用宏基因组学评估粪便中病毒、真核生物和古菌的组成，以及细菌的抗生素抗性基因（ARG）和毒力因子（VF）。
与HCG相比，HIG全消化道黏膜和胃液中细菌的α和β多样性显示出显著变化，微生物失调指数增加，在门和属水平上组成有显著差异。功能途径分析显示，HIG中菌群的代谢特征发生变化，存在部位特异性差异。两组粪便样本在上述指标上无显著差异。此外，基于粪便的宏基因组分析显示，仅真核生物在HIG中具有更高的多样性，而病毒和古菌无显著变化；ARG的香农指数增加；VF无显著变化。
本研究表明，H. pylori感染显著影响消化道不同部位和胃液中细菌的多样性、组成和代谢功能途径。此外，粪便微生物组成可能无法完全代表胃肠道黏膜微生物组成。
中国临床试验注册中心：ChiCTR2300073419。
