H. pylori eradication with antibiotic treatment causes changes in glucose homeostasis related to modifications in the gut microbiota.
Martín-Núñez GM, Cornejo-Pareja I, Coin-Aragüez L, Roca-Rodríguez MDM, Muñoz-Garach A, Clemente-Postigo M, Cardona F, Moreno-Indias I, Tinahones FJ
PLoS One. 2019. doi: 10.1371/journal.pone.0213548
COMMENT: Previous studies have associated H. pylori infection and eradication with glucose homeostasis but the mechanisms underlying this association are unclear. This paper analyze whether the infection and eradication treatment of H. pylori may cause perturbations in the gut microbiome, which can indirectly affect carbohydrate homeostasis. The study included two samples, one prior to and one two months after the 10 days antibiotic eradication treatment. The microbiota composition in fecal samples was determined by 16S rRNA gene (V3-V4) sequencing using Illumina Miseq.
This study aims to evaluate whether the alterations in intestinal microbiota composition produced by H. pylori infection and its posterior eradication with antibiotic treatment could be associated with glucose homeostasis in metabolically healthy subjects.
H. pylori eradication with antibiotic treatment produces specific bacterial changes associated with an improvement in glucose homeostasis and HbA1c (Glycosylated Hemoglobin) levels in patients with normal blood glucose concentrations.
We observed a lower presence of the Rikenellaceae family, the Butyricimonas genus and E. biforme and a greater presence of B. Fragilis and Megamonas genus in patients after H. pylori eradication treatment.
Significant changes in relative abundance comparing controls and patients before and after H. pylori eradication treatment were found in our study. Bacteroidetes was the most representative phylum among the H. pylori patients at pre- and post-eradication time points.
we found a decrease in the relative abundance of Actinobacteria post-H. pylori eradication compared with pre-H. pylori eradication and controls
..within the Actinobacteria phylum, we found that the H. pylori eradication treatment led to a significant decrease in the relative abundance of the family Bifidobacteriaceae, and especially in the genus Bifidobacterium and B. longum and B. adolescentis species. Firmicutes and Proteobacteria phyla also experimented a decrease after the H. pylori eradication treatment, specifically a decrease in the relative abundance of the family Streptococcaceae and the genus Streptococcus...
Significant univariate correlations were found between changes in the amount of specific bacteria and the proportion of changes in the glucose AUC (Area Under the Glucose Curve).
Multivariate regression analyses, for all the bacterial groups analyzed, were assessed. Only the changes in Rikenellaceae and Butyricimonas predicted the proportion of changes in the glucose AUC in patients after the eradication treatment. These results remained statistically significant even after correcting for age, sex and BMI.
These findings suggest that compositional changes in the gut microbiota produced by H. pylori eradication with antibiotic treatment could be related, with the glucose homeostasis of the host. The involvement of glucose-removing bacteria such as Rikenellaceae and Butyricimonas, as well as the increase Short Chain Fatty Acid (SCFA) -producing bacteria as Megamonas, could play a role in this association.