The Effect Of Helicobacter Pylori Eradication On The Gastrointestinal Flora In Peptic Ulcer

Background: There has been a dramatic increase in studies on the potential mechanistic role of intestinal flora in various diseases.Recent reports indicated that Helicobacter pylori(Hp)might have an effect on the gastrointestinal flora,moreover,gastric commensal bacteria are observed in the development of peptic ulcer(PU),including gastric ulcer(GU)and duodenal ulcer(DU).In our study,we aimed to observe the effect of Hp eradication on gastrointestinal flora in PU patients with completely cure.Methods: A case-control study in China was performed at Jiangsu Shengze Hospital from December,2013 to April,2014.Gastric mucous and feces specimens were used to extract bacteria DNA to quantify the numbers of Lactobacillus group,BacteroidesPrevotella group,Clostridium leptum subgroup,Clostridium coccoides subgroup,Bacteroides fragilis group,Enterobacteria by real-time polymerase chain reaction(PCR)using 16 Sr RNA primers.All data were collated and analyzed with SPSS version 17.Results: Following institutional ethical approval,40 DU cases,9 GU cases and 30 chronic gastritis cases served as controls were enrolled.23 DU patients and 3 GU patients completed the study.There was no statistically significant difference of the bacteria in GU patients before and after healing of ulcers.However,in Hp-related DU cases,after the eradication of Hp and cure of ulcer,an increase of Lactobacillus group,Clostridium leptum subgroup,Enterobacteria and a decrease of Clostridium coccoides subgroup were seen in the antrum.In the corpus,the number of Lactobacillus group was increased and the expression of Clostridium coccoides subgroup was significantly down-regulated.In feces samples,only the number of Lactobacillus group was increased.On the other hand,an increase of Clostridium leptum subgroup in both the antrum(p=0.031)and the corpus(p=0.034)and a decrease of Enterobacteria in the feces sample(p=0.004)were found in the female DU patients after Hp eradication.However,in the male DU patients,the expression of Lactobacillus group(p=0.008)and Prevotella(p=0.022)in the antrum was upregulated significantly after Hp eradication,respectively.Conclusions: The existence of Hp in stomach suppressed the colonization of Lactobacillus group,Clostridium leptum subgroup and Enterobacteria.And Lactobacillus group could promote the healing of duodenal ulcer.Gender is an influencing factor that could have an effect on the bacteria distribution and/or recolonization in DU patients.