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C inflammation with Helicobacter pylori (H. pylori) is a major risk factor for gastric cancer, but only less than 3% of H. pylori-infected people develop gastric cancer.(1) As plausible explanations for these discrepancies, host changes in gut microbial composition are associated with intestinal metaplasia (IM), chronic atrophic gastritis (CAG), and gastric adenoma as precancerous lesions and gastric cancer, that is, the role of bacteria other than H. pylori is yet to be established.(2–4) A significant percentage of cancers arise from chronic microbial infections and consequent mutagenic inflammation, H. pylori infection and gastric cancer via gut microbiota changes is regarded as hallmarks of cancer-inducing microbe.(5) However, interventions using probiotics are still obscure implication, though the eradication is actively progressing in Japan in order to prevent H. pylori-associated CAG and cancer.(6–9) Recent publications aimed to explore responsible gut or gastric microbiota in patients with different degree of gastritis including H. pylori and non-H. pylori bacteria were available;(10–12) profound alterations in human fecal microbiota of H. pylori infected individuals, the increased microbiota diversity associated with H. pylori infection, relative abundance of specific genera, all reflected the complex networking between H. pylori and its human host and gastric tumor microenvironment. For instances, H. pylori-infected individuals was shown to be increased of abundance of Candida glabrata and other unclassified fungi in addition to Succinivibrio, Coriobacteriaceae, Enterococcaceae, and Rikenellaceae,(13) linking possible role for H. pylori-associated changes in the gut microbiota in producing precancerous lesion as well as early stage gastric cancer, the knowledge and information may eventually lead to the development of novel biomarkers or therapeutic intervention.(14) Put together of above backgrounds, we set hypothesis that fermented diet intervention might be ideal because food contains profuse and diverse kinds of probiotics, safety with longterm intake of food, and associated phytochemicals warranting rejuvenating actions of precancerous atrophic changes in food, ascertained antioxidative and anti-inflammatory actions of phytochemicals included in food,(15–21) considering the fact that accepted benefits of probiotic supplementation are relieving more gastrointestinal symptoms, some improvement in host immune responses, increasing compliance of eradication regimen, and increases of eradication rate.(17,22,23) Although consumption of over-the-counter probiotics to promote health has increased worldwide, there are conflicting clinical results that many probiotic strains and formulations can aggravate underlying diseases reported in high impact journal, so called possibility of “probiotics paradox”.(24–26) Supported with facts that H. pylori as well as gut microbiota can be determining environmental factors influencing gastric pathologies including precancerous CAG as well as gastric cancer, in order to maintain the gut homeostasis and defensive condition against H. pylori infection, the modulation of gut microbiota with probiotics foods, fermented kimchi in the current study, can be basis for either ameliorating gastritis or rejuvenating atrophy, we have performed clinical trials to explore

journal of clinical biochemistry and nutrition

Microbiota changes with fermented kimchi contributed to either the amelioration or rejuvenation of &lt;i&gt;Helicobacter pylori&lt;/i&gt;-associated chronic atrophic gastritis