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Gastric microbiota is altered in oesophagitis and B arrett's oesophagus and further modified by proton pump inhibitors
Author(s) -
Amir Itay,
Konikoff Fred M.,
Oppenheim Michal,
Gophna Uri,
Half Elizabeth E.
Publication year - 2014
Publication title -
environmental microbiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.954
H-Index - 188
eISSN - 1462-2920
pISSN - 1462-2912
DOI - 10.1111/1462-2920.12285
Subject(s) - gastroenterology , heartburn , medicine , proton pump inhibitor , intestinal metaplasia , dysplasia , reflux , cancer , biology , esophagus , helicobacter pylori , disease
Summary Gastro‐oesophageal reflux can cause inflammation, metaplasia, dysplasia and cancer of the oesophagus. Despite the increased use of proton pump inhibitors ( PPIs ) to treat reflux, the incidence of oesophageal adenocarcinoma has increased rapidly in E urope and in the U nited S tates in the last 25 years. The reasons for this increase remain unclear. In this study, we aimed to determine whether the microbiota of the gastric refluxate and oesophageal biopsies differs between patients with heartburn and normal‐appearing oesophageal mucosa versus patients with abnormal oesophageal mucosa [oesophagitis or B arrett's oesophagus ( BE )] and to elucidate the effect of PPIs on the bacterial communities using 16 S rRNA gene pyrosequencing. Significant differences in the composition of gastric fluid bacteria were found between patients with heartburn and normal oesophageal tissue versus patients with oesophagitis or BE , but in the oesophagus‐associated microbiota differences were relatively modest. Notably, increased levels of E nterobacteriaceae were observed in the gastric fluid of oesophagitis and BE patients. In addition, treatment with PPIs had dramatic effects on microbial communities both in the gastric fluids and the oesophageal tissue. In conclusion, gastric fluid microbiota is modified in patients with oesophagitis and BE compared with heartburn patients with normal biopsies. Furthermore, PPI treatment markedly alters gastric and oesophageal microbial populations. Determining whether the changes in bacterial composition caused by PPIs are beneficial or harmful will require further investigation.