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Meta-Analysis
. 2022 May 4:12:899248.
doi: 10.3389/fcimb.2022.899248. eCollection 2022.

Effect of Helicobacter Pylori Eradication on Human Gastric Microbiota: A Systematic Review and Meta-Analysis

Yang Guo  1 , Xue-Shan Cao  2 , Guan-Yi Guo  3 , Meng-Ge Zhou  4 , Bo Yu  1
Affiliations
Meta-Analysis

Effect of Helicobacter Pylori Eradication on Human Gastric Microbiota: A Systematic Review and Meta-Analysis

Yang Guo et al. Front Cell Infect Microbiol. .

Abstract

Background: Helicobacter pylori (H. pylori) infection is a major risk factor for gastric cancer and eradication of H. pylori is recommended as an effective gastric cancer prevention strategy. The infected individuals show microbial dysbiosis of gastric microbiota. In recent years, agrowing number of studies have focused on gastric microbiota changes following H. pylori eradication. In the present study, we aim to evaluate the influence of successful H. pylori eradication on the short-term and long-term alterations of human gastric microbiota using a method of systematic review and meta-analysis.

Methods: We did a systematic search based on three databases (PubMed, EMBASE, and Web of Science) in November 2021. Additional articles were also identified by reviewing references cited in the included papers. Human studies that reported changes in gastric microbiota following successful H. pylori eradication were enrolled. PROSPERO registration number: CRD42021293796.

Results: In total, nine studies enrolling 546 participants were included. Regarding quadruple therapy, alpha diversity indexes increased within 1 month after eradication; significant differences in gastric microbial community structure between before and after eradication were also seen within 1 month. The trends of the above-mentioned diversity changes persisted with a follow-up of 6 months. The microbial composition altered significantly after eradication and the relative abundance of H. pylori-related taxa decreased. Accordingly, gastric commonly dominant commensals were enriched. Bioinformatic analyses of microbiota functions showed that bacteria reproduction-related pathways were down-regulated and pathways of gastric acid secretion, etc. were up-regulated. For triple therapy, similar trends of alpha diversity and beta diversity changes were observed in the short-term and long-term follow-up. Also, after eradication, H. pylori was not the gastric dominant bacteria and similar changes in gastric microbial composition were found. For gastric microbial interactions, a decrease in microbial interactions was seen after eradication. Additionally, regarding whether successful H. pylori eradication could restore gastric microbiota to uninfected status, the results remain controversial.

Conclusion: In conclusion, successful H. pylori eradication could reverse the gastric microbiota dysbiosis and show beneficial effects on gastric microbiota. Our findings may provide new insight for exploring the role of H. pylori and the whole gastric microbiota in gastric carcinogenesis.

Keywords: Helicobacter pylori; eradication; gastric microbiota; humans; meta-analysis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of literature identification and selection process.
Figure 2
Figure 2
Quality assessment of included studies using MINORS. MINORS, Methodological Index for Non-Randomized Studies.
Figure 3
Figure 3
Effect of successful H. pylori eradication on Shannon index. (A) Subgroup analysis according to types of therapy; (B) Subgroup analysis according to countries; (C) Subgroup analysis according to agents; (D) Subgroup analysis according to follow-up period. Forest plots describing weighted mean difference (WMD) with 95% confidence interval (CI) for included studies reporting Shannon index. OAC, omeprazole + amoxicillin + clarithromycin.
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