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World J Gastroenterol. Oct 7, 2021; 27(37): 6224-6230
Published online Oct 7, 2021. doi: 10.3748/wjg.v27.i37.6224
Impact of Helicobacter pylori infection on gut microbiota
Chikara Iino, Tadashi Shimoyama
Chikara Iino, Tadashi Shimoyama, Department of Gastroenterology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan
Tadashi Shimoyama, Department of Internal Medicine, Aomori General Health Examination Center, Aomori 030-0962, Japan
Author contributions: Iino C and Shimoyama T designed the review; Iino C interpreted the data and drafted the manuscript; Shimoyama T critically revised the paper.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest regarding the publication of this paper.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tadashi Shimoyama, FACG, MD, PhD, Director, Department of Internal Medicine, Aomori General Health Examination Center, 2-19-12 Tsukuda, Aomori 030-0962, Japan. tsimo@hirosaki-u.ac.jp
Received: March 16, 2021
Peer-review started: March 16, 2021
First decision: April 29, 2021
Revised: May 13, 2021
Accepted: September 2, 2021
Article in press: September 2, 2021
Published online: October 7, 2021
Processing time: 190 Days and 5.6 Hours
Abstract

A number of studies have revealed the association between Helicobacter pylori (H. pylori) infection and the gut microbiota. More than half of the investigations on the impact of H. pylori on the gut microbiota have been the sub-analyses of the influence of eradication therapy. It was observed that H. pylori eradication altered gut microbiota within a short period after eradication, and majority of the alterations took a long period of time to reverse back to the original. Changes in the gut microbiota within a short period after eradication may be attributed to antibiotics and proton pump inhibitors. Modification of gastric acidity in the stomach caused by a long-term H. pylori infection alters the gut microbiota. Analysis of the gut microbiota should be conducted in a large population, adjusting for considerable biases associated with the composition of the gut microbiota, such as age, sex, body mass index, diet and the virulence of H. pylori.

Keywords: Helicobacter pylori; Gut microbiota; Atrophic gastritis; Eradication; Proton pump inhibitor

Core Tip: Helicobacter pylori (H. pylori) eradication alters gut microbiota within a short period after eradication; this is attributed to antibiotics and proton pump inhibitors. However, most of these alterations reverse back to baseline levels over a long period of time. Modification of acidity in the stomach with mucosal atrophy caused by H. pylori infection alters the gut microbiota. As the human gut microbiome is diverse among individuals, a large population size is needed to study. Adjustment of biases associated with the composition of the gut microbiota is also crucial for accurate evaluation of the association between H. pylori infection and the gut microbiota.