Gastric microbiota dysbiosis and Helicobacter pylori infection

Abstract

Helicobacter pylori (H. pylori) infection is one of the most common causes of gastric disease. The persistent increase in antibiotic resistance worldwide has made H. pylori eradication challenging for clinicians. The stomach is unsterile and characterized by a unique niche. Communication among microorganisms in the stomach results in diverse microbial fitness, population dynamics, and functional capacities, which may be positive, negative, or neutral. Here, we review gastric microecology, its imbalance, and gastric diseases. Moreover, we summarize the relationship between H. pylori and gastric microecology, including non-H. pylori bacteria, fungi, and viruses and the possibility of facilitating H. pylori eradication by gastric microecology modulation, including probiotics, prebiotics, postbiotics, synbiotics, and microbiota transplantation.

Keywords: H. pylori eradication; bacterial interaction; gastric diseases; gastric microecology; microbiota transplant.

FIGURE 1

Gastric microecological imbalance and gastric diseases. Despite the differences among individuals, there are five dominant bacterial phyla in the healthy stomach, and their common dominant bacterial genera are summarized (green). The gastric microbiota is dynamically balanced and affected by many factors, such as Helicobacter pylori infection, probiotics, gut microbiota, drugs, diet, and age. Although the causal relationship between them is unclear, gastric microecological imbalances are associated with various gastric diseases (red), and some microorganism-related disorders are listed.

FIGURE 2

Individualized reconstruction of the healthy gastric microbiota is a promising strategy for managing microecology dysbiosis-associated gastric diseases. Gastric microbiota composition and abundance and the interaction between gastric microbiomes (including Helicobacter pylori and non-H. pylori bacteria, fungi, and viruses) play important roles in gastric microecological homeostasis. Modulating the microbiota (probiotics, prebiotics, postbiotics, synbiotics, and FMT/GMT) is expected to improve and restore the gastric microflora balance. However, individualized treatment options, such as the bacteria type or donor selection, delivery path, and start and end times, require further study. FMT, fecal microbiota transplantation; GMT, gastric microbiota transplantation.