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Changes in the gut microbiota composition and the plasma ghrelin level in patients with Helicobacter pylori-infected patients with eradication therapy
  1. Hidetaka Yanagi1,
  2. Ayumi Tsuda1,
  3. Masashi Matsushima2,
  4. Shunsuke Takahashi3,
  5. Genki Ozawa3,
  6. Yasuhiro Koga4,
  7. Atsushi Takagi1
  1. 1 Department of General Medicine, Tokai University School of Medicine, Isehara, Japan
  2. 2 Department of Gastroenterology, Tokai University School of Medicine, Isehara, Japan
  3. 3 Technical Department, TechnoSuruga Laboratory Co. Ltd, Shizuoka, Japan
  4. 4 Laboratory for Infectious Diseases, Tokai University School of Medicine, Isehata, Japan
  1. Correspondence to Dr Yasuhiro Koga; yasuhiro{at}


Objective To investigate the influence of antimicrobials on both the gut microbiota structure and the plasma ghrelin level using Helicobacter pylori-infected patients who underwent eradication therapy.

Design Twenty H. pylori-infected patients (mean age 68.3 years old) who underwent eradication therapy participated in the study. For the therapy, patients had 1 week of triple therapy consisting of amoxicillin, clarithromycin and proton-pump inhibitors. Stool and blood samples were obtained before (S1), immediately after (S2) and/or 3 months after (S3) the therapies. The concentrations of ghrelin and leptin in the blood were assayed using an ELISA. The V3-V4 region of the 16S rRNA gene was amplified using bacterial DNA from the stool, and about 50 000 high-quality amplicons per sample were grouped into operational taxonomic units for bacteriological analyses.

Results The Bacteroidetes:Firmicutes (B:F) ratio was significantly greater at S3 than S1 (P<0.01). This increase in the B:F ratio between S3 and S1 was found in 15 out of 20 patients. A significant decrease in the concentration of active ghrelin (P=0.003) in the plasma was observed between S3 and S1. There was a statistically significant correlation between the rate of patients whose B:F ratio increased and that of patients whose active ghrelin level decreased between S3 and S1 according to Fisher’s exact probability test (P=0.03).

Conclusions Changes in the gut microbiota, such as the B:F ratio after treatment with antimicrobials, might cause a change in the plasma ghrelin level, as the direct and earliest target of antimicrobials would be the microbiota rather than the hormone-secreting system.

  • antibiotic therapy
  • helicobacter pylori
  • intestinal microbiology
  • obesity

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  • Contributors HY, AyT and MM recruited the H. pylori-infected patients undergoing eradication therapy and performed biochemical examinations. ST and GO performed bacteriological, genetical and statistical analyses. YK was involved in the study design and drafting the manuscript. AtT was involved in the study design and data interpretation.

  • Funding This study was funded by Meiji Co, Ltd (Tokyo, Japan).

  • Competing interests None declared.

  • Ethics approval The ethics committee of Tokai University Hospital approved the study (15 R-160).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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