港中大团队:胃部菌群与胃癌发生的关系
创作:王文东 审核:nana 03月01日
  • 587名幽门螺杆菌(H. pylori)阳性患者,分别接受H. pylori根除或安慰剂;
  • 根除1年后胃部菌群互作减少,安慰剂组基本不变;
  • 根除H. pylori后的胃炎患者,鲁氏不动杆菌和咽峡炎链球菌等增高, Roseburia菌属和鞘氨醇单胞菌属等减少;
  • 口腔中消化链球菌属和链球菌属等细菌,与胃萎缩(GA)和肠上皮化生(IM)的发生和持久性相关;
  • 根除H. pylori后GA患者F. praustznii减少,IM患者氨基酸和肌醇磷酸代谢增加、叶酸合成和NOD样受体信号减少。
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nana
感染幽门螺旋杆菌的个体中,只有不到3%会发展为胃癌,约20%的慢性胃炎患者为幽门螺旋杆菌阴性,其他微生物可能引起胃炎症和胃癌发生。Gut近期发表来自香港中文大学文章,对接受根除幽门螺旋杆菌治疗的患者与接受安慰剂治疗的患者进行了为期一年的回顾性研究,发现根除幽门螺旋杆菌后,胃部其它微生物与胃炎症、胃萎缩和胃黏膜的肠上皮化生(即胃粘膜中出现类似小肠或大肠粘膜的上皮细胞,可能促进癌变)相关。本研究结果提示,在没有幽门螺旋杆菌的情况下,胃微生物在胃癌前期病变的发展和持续过程中具有潜在作用,这或可作为预防胃癌发生的治疗靶点。
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Gut [IF:19.819]

Gastric microbes associated with gastric inflammation, atrophy and intestinal metaplasia 1 year after Helicobacter pylori eradication

幽门螺杆菌根除1年后,与胃炎、胃萎缩和肠上皮化生相关的胃部菌群;

10.1136/gutjnl-2019-319826

01-23, Article

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Objective : Helicobacter pylori is associated with gastric inflammation, precancerous gastric atrophy (GA) and intestinal metaplasia (IM). We aimed to identify microbes that are associated with progressive inflammation, GA and IM 1 year after H. pylori eradication.
Design : A total of 587 H.pylori–positive patients were randomised to receive H. pylori eradication therapy (295 patients) or placebo (292 patients). Bacterial taxonomy was analysed on 404 gastric biopsy samples comprising 102 pairs before and after 1 year H. pylori eradication and 100 pairs before and after 1 year placebo by 16S rRNA sequencing.
Results: Analysis of microbial sequences confirmed the eradication of H. pylori in treated group after 1 year. Principal component analysis revealed distinct microbial clusters reflected by increase in bacterial diversity (p<0.00001) after H. pylori eradication. While microbial interactions remained largely unchanged after placebo treatment, microbial co-occurrence was less in treated group. Acinetobacter lwoffii, Streptococcus anginosus and Ralstonia were enriched while Roseburia and Sphingomonas were depleted in patients with persistent inflammation 1 year after H. pylori eradication. A distinct cluster of oral bacteria comprising Peptostreptococcus, Streptococcus, Parvimonas, Prevotella, Rothia and Granulicatella were associated with emergence and persistence of GA and IM. Probiotic Faecalibacterium praustznii was depleted in subjects who developed GA following H. pylori eradication. Functional pathways including amino acid metabolism and inositol phosphate metabolism were enriched while folate biosynthesis and NOD-like receptor signalling decreased in atrophy/IM-associated gastric microbiota.
Conclusion : This study identified that gastric microbes contribute to the progression of gastric carcinogenesis after H. pylori eradication.

First Authors:
Joseph J Y Sung

Correspondence Authors:
Joseph J Y Sung

All Authors:
Joseph J Y Sung,Olabisi Oluwabukola Coker,Eagle Chu,Chun Ho Szeto,Simson Tsz Yat Luk,Harry Cheuk Hay Lau,Jun Yu

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