AUTHOR=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 

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

JOURNAL=Frontiers in Cellular and Infection Microbiology

VOLUME=12

YEAR=2022

URL=https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2022.881968

DOI=10.3389/fcimb.2022.881968

ISSN=2235-2988

ABSTRACT=<p>The combination of vonoprazan (VPZ) and amoxicillin (VA therapy) has been shown to achieve acceptable eradication rates for <italic>Helicobacter pylori</italic> (<italic>H. pylori</italic>). 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 <italic>H. pylori</italic>-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 <italic>H. pylori</italic>-negative patients served as controls. Fecal samples were collected from <italic>H. pylori</italic>-positive and <italic>H. pylori</italic>-negative patients. The gut microbiota and SCFAs were analyzed using 16S rRNA gene sequencing and gas chromatography–mass spectrometry, respectively. The gut microbiota in <italic>H. pylori</italic>-positive patients exhibited increased richness, diversity, and better evenness than matched patients. Fifty-three patients studied before and after <italic>H. pylori</italic> 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 <italic>Anaerostipes</italic>, <italic>Dialister</italic>, and <italic>Lachnospira</italic> induced by H-VA was associated with altered SCFA levels. VA dual therapy for <italic>H. pylori</italic> eradication has minimal negative effects on gut microbiota and SCFAs.</p>