| 【Backgrounds】Helicobacter pylori （H.pylori） is a common and potentially curable cause ofpeptic ulcer disease. Current guidelines recommend testing and treating of H.pylori infection for patients with peptic ulcer disease. The standard tripletreatment including PPI-clarithromycin and amoxicillin proposed to treat H. pyloriinfection has become universal. However, H. pylori eradication therapy mayinduce many side effects and affect the gut microbiota which impact human healththereby. The adding of certain probiotics as an adjuvant treatment may reduce sideeffects and correcte intestinal flora disturbance.【Aims】In this study, we want to evaluate the impact of the probiotics adding with thestandard triple treatment, and to explore the differences between the probioticsadding and without on the gut microbiota. Furthermore, we also want to evaluate whether the probiotics canimprove the gut microbiota or not.【Methods】We recruited40H.pylori infected patients with duodenal ulcer who wererandomized into a triple-plus-probiotics （TP） group and a triple-only treatment（TT）group.20cases of health people as health control group（HC）were alsorecruited.The participants received2weeks of triple therapy with or without theprobiotics supplement. For the TP group, the probiotics adding was continued for4weeks. All the clinlcal symptoms and side effects during or after the treatmentwere observed and recorded.4weeks after therapy, patients should takegastroendoscopy and13C-urea breath test again. Fecal samples at the beginning ofthe treantment,2weeks,6weeks and10weeks after the treatment were collected.The V4region of the16S rDNA gene was extracted from all the samples by PCRto assess the alteration of the intestinal microbiota through the high-fluxsequencing platform of Illumina Miseq.【Results】Young and mid-aged men have high incidence of DU. The pH value（0.72） of thegastric juice was significantly lower in DU patients than the normal（1.27）. Afteranti-H.pylori treatment, the value can return to normal. The ulcer healing rate（90%vs100%）and H.pylori eradication rate（80%vs85%）have no difference betweenthe TT and TP group. TT group have higher incidence rate of side effects than TPgroup（35%vs20%, P <0.05）, and the main symptoms are diarrhea, nausea andabdominal pain. The adverse events were mostly happened during the treatment,85.7%of which are mild or moderate. TP therapy can significantly improve theclinical symptoms, improve treatment tolerability and reduce the incidence ofadverse reactions, especially on the incidence of diarrhea compared with the TTtherapy.16S rDNA sequencing analysis reveales the average OTUs are875in HCgroup,635in TT and725in TP group. Although the proportion are different,more than96%of the total amount are the Bacteroidetes、Firmicutes andProteobacteria in the two groups. The predominant genus in the two groups are different. In the TT group, Bacteroides（30.3%）、Escherichia（14.9%）、Prevotella（10.7%）、Faecalibacterium（6.0%）and Parabacteroides（2.6%）are identifiedas the top five abundant microbial genus. While in TP group, the top five genusare Bacteroides（27.1%）、Escherichia（10.0%）、Faecalibacterium（6.8%）、Prevotella（5.2%）and Phascolarctobacterium（3.7%）.Anti-H.pylori treatment canreduce gut microbiotic diversity, especially the Firmicutes phylum. Both groupshave the same recovery trend at the6thweek, while only the TP group continuts torecover at the10thweek.Principal component analysis shows the overlapping ofmost samples between TP and HC group,while little samples between TT and HC.【Conclusion】TP therapy can reduce the incidence of adverse events caused by TT therapy. Gutmicrobiotic adiversity in DU patients is less than the HC. Anti-H.pylori treatmentresultes in continuing decline of the gut microbiota adiversity. After4weeks, thegut microbiota returns to the nearly normal, especially in TP group. Whencompared with the HC group microbiota composition, TP group has moresimilary microbiota composition than the TT group. |
PDF Full Text Request