The effect of gut microbiota disorders in patients with chronic Helicobacter pylori-associated gastroduodenitis

Objective: to identify correlations between the level of various microorganisms in the gut and clinical, endoscopic, morphological and psychosomatic manifestations of chronic gastroduodenitis (CGD) associated with Helicobacter pylori (HP). Materials and methods: We examined 103 patients with CGD associated with HP. All patients underwent a comprex examination, which included: assessment of complaints, endoscopic examination of the upper gastrointestinal tract with an assessment of hyperemia, edema, erosive changes in the gastric and duodenal mucosa, verification of HP infection (rapid urease test, histological examination, molecular genetic examination), histological examination of the body mucosa and antral stomach with the detection of neutrophil and lymphoplasmocytic infiltration, hemorrhage, edema, signs of atrophy, metaplasia, dysplasia), bacteriological examination of feces to assess the state of the gut microbiota, psychological testing to assess the level of anxiety and depression. To identify possible relationships between the manifestations of CGD and changes of the gut microbiota a correlation analysis was performed. Results: a decrease in the levels of obligate normoflora (bifidobacteria, lactobacilli) and an increase in the levels of opportunistic microorganisms, staphylococci and yeast-like fungi Candida in the gut were associated with an increase in the severity of clinical, endoscopic and histological signs of CGD, as well as an increase in anxiety and depression signs. Correlations between the degree of HP contamination of the gastric mucosa and the level of Bifidobacteria spp. and Candida spp. in the gut were revealed: the degree of HP contamination of the stomach body was lower with a sufficient content of Bifidobacteria spp. (r= -0.29, p=0.029) and increased both in the body (r=0.28, p=0.032) and in the antrum (r=0.30, p=0.006) with increasing of the number of Candida spp. in the gut. Conclusions: The identification of the relationship between the presence of HP in the stomach and disorders of the gut microbiota can contribute to the expansion of ideas about the pathogenesis of helicobacteriosis, as well as serve as a constructive basis for developing recommendations to improve the effectiveness and safety of treatment for diseases associated with HP infection, in particular, through the use of drugs for the correction of gut microbiota disorders.

Helicobacter pylori, gastritis, gastroduodenitis, microbiota, dysbiosis

1. De Musis C., Granata L., Dallio M., Miranda A., Gravina A. G., Romano M. Inflammatory Bowel Diseases: The Role of Gut Microbiota. Curr Pharm Des. 2020;26(25):2951-2961. doi: 10.2174/1381612826666200420144128

2. Gomaa E. Z. Human gut microbiota/microbiome in health and diseases: a review. Antonie Van Leeuwenhoek. 2020 Dec;113(12):2019-2040. doi: 10.1007/s10482-020-01474-7

3. Kim S., Jazwinski S. M. The Gut Microbiota and Healthy Aging: A Mini-Review. Gerontology. 2018;64(6):513-520. doi: 10.1159/000490615

4. Roy Sarkar S., Banerjee S. Gut microbiota in neurodegenerative disorders. J Neuroimmunol. 2019 Mar 15;328:98-104. doi: 10.1016/j.jneuroim.2019.01.004

5. Yamashita T., Emoto T., Sasaki N., Hirata K. I. Gut Microbiota and Coronary Artery Disease.Int Heart J. 2016 Dec 2;57(6):663-671. doi: 10.1536/ihj.16-414

6. Oleskin A.V. [Biopolitics. The Political Potential of Modern Biology: Philosophical, Political Science and Practical Aspects]. Moscow. Izdatel’stvo Instituta filosofii RAN Publ., 2001. 423 P. (In Russian)@@ Олескин А. В. Биополитика. Политический потенциал современной биологии: философские, политологические и практические аспекты. М: Издательство Института философии РАН, 2001. - 423 с.

7. Tkachenko E.I., Uspenskii Yu. P. Nutrition, microbiocenosis and human intelligence. SPb. SpetsLit Publ., 2006. 590 р. (In Russian)@@ Ткаченко Е. И., Успенский Ю. П. Питание, микробиоценоз и интеллект человека. - СПб.: СпецЛит, 2006. - 590 с.

8. Baryshnikova N.V., Gurova M. M., Ivanova I. I., et al. [Gastrointestinal microbiota in chronic gastritis]. Sankt-Peterburg, 2014. (In Russian)@@ Барышникова Н. В., Гурова М. М., Иванова И. И., и соавт. Микробиота желудочно-кишечного тракта при хроническом гастрите. Под редакцией А. Н. Суворова, В. П. Новиковой, И. Ю. Мельниковой. Санкт-Петербург, 2014.

9. Krulevskii V.A., Petrovskii A. N., Anichkov N. M., Novikova V. P. [Chronic gastritis and herpetic infections in persons of different ages]. Pathology Archive. 2010;72(1):33-35. (In Russian)@@ Крулевский В. А., Петровский А. Н., Аничков Н. М., Новикова В. П. Хронический гастрит и герпетические инфекции у лиц разного возраста. Архив патологии. 2010. Т. 72. № 1. С. 33-35.

10. Bristol scale of feces forms. Available at: URL: https://gastritinform.ru/tipy-kala-po-bristolskoj-shkale/ (Access: 21.12.2021). @@ Типы кала по Бристольской шкале [электронный ресурс]. URL: https://gastritinform.ru/tipy-kala-po-bristolskoj-shkale/ (дата обращения 21.12.2021).

11. Zigmond A.S., Snaith R. P. The hospital Anxiety and Depression Scale. Acta. Psychiatr. Scand. 1983;(67):361-370.

12. Tsung Depression Self-Report Scale. Available at: https://psytests.org/clinical/zung-run.html (Access: 01.08.2021). (In Russian)@@ Шкала самооценки депрессии Цунга [электронный ресурс]. URL: https://psytests.org/clinical/zung-run.html (дата обращения 01.08.2021).

13. Luchkevich V.S., Pivovarov A. N., Anisimov R. P., et al. [Fundamentals of correlation analysis in a comprehensive assessment of public health]. SPb. SPbGMA, 1998. 40 P. (In Russian)@@ Лучкевич В. С., Пивоваров А. Н., Анисимов Р. П. и др. Основы корреляционного анализа в комплексной оценке здоровья населения (учебное пособие). - СПб.: СПбГМА, 1998. - 40 с.