Objective Helicobacter pylori is associated with gastric inflammation, precancerous gastric atrophy (GA) and intestinal metaplasia (IM). We aimed to identify microbes that are associated with progressive inflammation, GA and IM 1 year after H. pylori eradication. Design A total of 587 H. pylori–positive patients were randomised to receive H. pylori eradication therapy (295 patients) or placebo (292 patients). Bacterial taxonomy was analysed on 404 gastric biopsy samples comprising 102 pairs before and after 1 year H. pylori eradication and 100 pairs before and after 1 year placebo by 16S rRNA sequencing. Results Analysis of microbial sequences confirmed the eradication of H. pylori in treated group after 1 year. Principal component analysis revealed distinct microbial clusters reflected by increase in bacterial diversity (p<0.00001) after H. pylori eradication. While microbial interactions remained largely unchanged after placebo treatment, microbial co-occurrence was less in treated group. Acinetobacter lwoffii, Streptococcus anginosus and Ralstonia were enriched while Roseburia and Sphingomonas were depleted in patients with persistent inflammation 1 year after H. pylori eradication. A distinct cluster of oral bacteria comprising Peptostreptococcus, Streptococcus, Parvimonas, Prevotella, Rothia and Granulicatella were associated with emergence and persistence of GA and IM. Probiotic Faecalibacterium praustznii was depleted in subjects who developed GA following H. pylori eradication. Functional pathways including amino acid metabolism and inositol phosphate metabolism were enriched while folate biosynthesis and NOD-like receptor signalling decreased in atrophy/IM-associated gastric microbiota. Conclusion This study identified that gastric microbes contribute to the progression of gastric carcinogenesis after H. pylori eradication.

中文翻译：

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幽门螺杆菌根除1年后与胃炎症、萎缩和肠化生相关的胃微生物

目的幽门螺杆菌与胃炎症、癌前胃萎缩（GA）和肠上皮化生（IM）有关。我们的目标是确定与幽门螺杆菌根除 1 年后进行性炎症、GA 和 IM 相关的微生物。设计 总共 587 名 H. pylori 阳性患者随机接受 H. pylori 根除治疗（295 名患者）或安慰剂（292 名患者）。通过 16S rRNA 测序，对 404 份胃活检样本进行了细菌分类分析，这些样本包括 102 对在根除幽门螺杆菌之前和之后的 100 对，以及在 1 年安慰剂之前和之后的 100 对。结果微生物序列分析证实治疗组在1年后根除幽门螺杆菌。主成分分析揭示了不同的微生物群，反映在幽门螺杆菌后细菌多样性的增加（p<0.00001）。根除幽门螺杆菌。虽然安慰剂治疗后微生物相互作用基本保持不变，但治疗组的微生物共存较少。在根除幽门螺杆菌后 1 年，持续炎症的患者中 lwoffii 不动杆菌、咽峡炎链球菌和 Ralstonia 被富集，而 Roseburia 和鞘氨醇单胞菌被耗尽。包括消化链球菌、链球菌、细小单胞菌、普氏菌、Rothia 和粒状菌在内的一组不同的口腔细菌与 GA 和 IM 的出现和持续存在相关。在根除幽门螺杆菌后发生 GA 的受试者中，益生菌 Faecalibacterium praustznii 被耗尽。在萎缩/IM相关的胃微生物群中，包括氨基酸代谢和肌醇磷酸酯代谢在内的功能途径得到丰富，而叶酸生物合成和NOD样受体信号传导减少。结论 本研究确定胃微生物有助于根除幽门螺杆菌后胃癌发生的进展。