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The Influence of Proton Pump Inhibitors on the Fecal Microbiome of Infants with Gastroesophageal Reflux—A Prospective Longitudinal Interventional Study
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The Influence of Proton Pump Inhibitors on the Fecal Microbiome of Infants with Gastroesophageal Reflux—A Prospective Longitudinal Interventional Study
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Journal Article
The Influence of Proton Pump Inhibitors on the Fecal Microbiome of Infants with Gastroesophageal Reflux—A Prospective Longitudinal Interventional Study
2017
Overview
Proton pump inhibitors (PPIs) are the standard therapy for gastroesophageal reflux disease. In adults, PPI treatment is associated with
infections (CDI). In contrast to adults the microbiome of infants develops from sterility at birth toward an adult-like profile in the first years of life. The effect of PPIs on this developing microbiome has never been studied. The aim of the present study was to determine the effect of oral PPIs on the fecal microbiome in infants with gastroesophageal reflux disease (GERD). In this prospective longitudinal study 12 infants with proven GERD received oral PPIs for a mean period of 18 weeks (range 8-44). Stool samples were collected before (\"before PPI\") and 4 weeks after initiation of PPI therapy (\"on PPI\"). A third sample was obtained 4 weeks after PPI discontinuation (\"after PPI\"). The fecal microbiome was determined by NGS based 16S rDNA sequencing. This trial was registered with clinicaltrials.gov (NCT02359604). In a comparison of \"before PPI\" and \"on PPI\" neither α- nor β-diversity changed significantly. On the genus level, however, the relative abundances showed a decrease of
and
and an increase of
. After PPI therapy there was a significant increase of α- and β-diversity. Additionally, the relative abundances of the phyla Firmicutes, Bacteroidetes, and Proteobacteria were significantly changed and correlated to patients' age and the introduction of solid foods. PPI treatment has only minor effects on the fecal microbiome. After discontinuation of PPI treatment the fecal microbiome correlated to patients' age and nutrition.
Publisher
Frontiers Media SA,Frontiers Media S.A
Subject
/ Clostridium difficile - genetics
/ Clostridium Infections - microbiology
/ Enzymes
/ Esomeprazole - therapeutic use
/ Feces
/ Female
/ Gastroesophageal Reflux - drug therapy
/ GERD
/ Humans
/ Infant
/ Infants
/ Male
/ Proton Pump Inhibitors - pharmacology
/ Proton Pump Inhibitors - therapeutic use
/ Protons
/ rRNA 16S
