Altered Gut Microbiota and Short-Chain Fatty Acids After Vonoprazan-Amoxicillin Dual Therapy for Helicobacter pylori Eradication

• Published in: Frontiers in cellular and infection microbiology Vol. 12; p. 881968
• Main Authors: Hu, Yi, Xu, Xin, Ouyang, Yao-Bin, He, Cong, Li, Nian-Shuang, Xie, Chuan, Peng, Chao, Zhu, Zhen-Hua, Shu, Xu, Xie, Yong, Lu, Nong-Hua, Zhu, Yin
• Format: Journal Article
• Language: English
• Published: Frontiers Media S.A 02.06.2022
• Subjects: amoxicillin; Cellular and Infection Microbiology; eradication; gut microbiota; Helicobacter pylori; short-chain fatty acids; vonoprazan
• ISSN: 2235-2988; 2235-2988
• DOI: 10.3389/fcimb.2022.881968

The combination of vonoprazan (VPZ) and amoxicillin (VA therapy) has been shown to achieve acceptable eradication rates for Helicobacter pylori ( H. pylori ). Herein, our aim was to explore the short-term effect of VA therapy on the gut microbiota and short-chain fatty acids (SCFAs) using human fecal samples. A total of 119 H. pylori -positive patients were randomized into low- or high-dose VA therapy (i.e., amoxicillin 1 g b.i.d. or t.i.d. and VPZ 20 mg b.i.d.) for 7 or 10 days. Thirteen H. pylori -negative patients served as controls. Fecal samples were collected from H. pylori -positive and H. pylori -negative patients. The gut microbiota and SCFAs were analyzed using 16S rRNA gene sequencing and gas chromatography–mass spectrometry, respectively. The gut microbiota in H. pylori -positive patients exhibited increased richness, diversity, and better evenness than matched patients. Fifty-three patients studied before and after H. pylori eradication were divided into low (L-VA) and high (H-VA) amoxicillin dose groups. The diversity and composition of the gut microbiota among L-VA patients exhibited no differences at the three time points. However, among H-VA patients, diversity was decreased, and the microbial composition was altered immediately after H-VA eradication but was restored by the confirmation time point. The decreased abundance of Anaerostipes , Dialister , and Lachnospira induced by H-VA was associated with altered SCFA levels. VA dual therapy for H. pylori eradication has minimal negative effects on gut microbiota and SCFAs.