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ORIGINAL RESEARCH article

Front. Nutr.
Sec. Nutrition and Microbes
Volume 11 - 2024 | doi: 10.3389/fnut.2024.1484646

Effect of probiotic supplementation combined with bismuth-containing quadruple therapy on gut microbiota during Helicobacter pylori eradication: a randomized, double-blind, placebo-controlled trial Author's names

Provisionally accepted
Zhongxue Han Zhongxue Han Yue-Yue Li Yue-Yue Li Xueping Nan Xueping Nan Tao Zhou Tao Zhou *Lixiang Li Lixiang Li *Yanqing Li Yanqing Li
  • Qilu Hospital, Shandong University, Jinan, China

The final, formatted version of the article will be published soon.

    Background: Helicobacter pylori (H. pylori) eradication has been reported to affect gut microbiota distribution. This study aimed to evaluate the effect of probiotic supplementation on the gastrointestinal microbiota during eradication and the efficacy of bismuth-containing quadruple therapy.Methods: One hundred treatment-naïve H. pylori-positive patients were randomly assigned 1:1 to receive 14-day bismuth-containing quadruple therapy (esomeprazole, bismuth, amoxicillin, and clarithromycin) combined with the probiotic (Bifidobacterium animalism subsp. lactis BLa80) or placebo. The Gastrointestinal Symptom Rating Scale (GSRS) was completed before and after treatment. Stool samples were collected for 16S rRNA gene sequencing at weeks 0, 2, and 10.No significant difference in the eradication rate was observed between the two groups. The incidence of adverse events, especially nausea (P = 0.029), was lower in the probiotic group. After treatment, the GSRS score decreased significantly in the probiotic group (P = 0.039). The gut microbiota underwent considerable changes immediately following eradication treatment, predominantly characterized by an increase in Proteobacteria at the expense of commensal Firmicutes and Bacteroidota, but gradually returned to baseline after eight weeks. By week 10, beneficial genera such as Lachnoclostridium, Parasutterella, Hungatella, and Akkermansia were notably enriched in the probiotic group. Additionally, the correlation networks in the probiotic group were closer to their initial levels at week 10 compared to the placebo group.Conclusions: Disturbances in the gut microbiota following H. pylori treatment appeared to be temporary, and probiotic supplementation could mitigate antibioticinduced alterations in the gut microbiota. This study also provided evidence supporting the effectiveness of probiotics in alleviating gastrointestinal symptoms.

    Keywords: Helicobacter pylori eradication, Probiotics, Gut Microbiota, 16S rRNA gene sequence, Bismuth quadruple therapy

    Received: 23 Aug 2024; Accepted: 03 Oct 2024.

    Copyright: © 2024 Han, Li, Nan, Zhou, Li and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Tao Zhou, Qilu Hospital, Shandong University, Jinan, China
    Lixiang Li, Qilu Hospital, Shandong University, Jinan, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.