The influence of proton pump inhibiter in human microbiota and metabolic production

Background and aimsProton pump inhibitor (PPI) is widely used for treatment against upper GI disorders, but the attention towards its adverse effects are rarely discussed. Wallace at el. has reported that PPI exacerbates NSAID-induced small intestinal injuries in rodent models (Gastroenterology 2011), and that the reduction of Bifidobacterium due to PPI treatment was related to this.Our aim was to figure out how the microbiome change in human, and to analyze the difference of metabolic production after PPI use.MethodsWe collected fecal samples from 21 healthy male volunteers before and after 14 days of 20mg daily omeprazole intake. The volunteers were restricted to eat foods that would affect the microbiome. The microbiome of the fecal samples were assessed using next generation sequencing platform (Illumina MiSeq). The metabolome of same samples were also analyzed.ResultsMicrobiome analysis showed that Actinobacteria phylum (p=0.016), especially Bifidobacterium genus (p<0.01) was significantly reduced after PPI use. Among the metabolic productions, Malic acid and Piperidine increased, and beta-Tyr decreased significantly after PPI use.ConclusionOur results showed that the same dysbiosis occurs in human subjects as rodent models, and this suggests that PPI use may exacerbate small intestinal injuries also in human. In addition, there were also changes among the metabolic production. Further study may reveal the pathogenesis of the PPI related adverse effects.