The influence of longterm use of proton pump inhibitors on the gut microbiota: An agesexmatched casecontrol study

Abstract

Proton pump inhibitors (PPIs) are widely used to treat gastro esophageal reflux and prevent gastric ulcers, and have been considered as low risk. However, recent studies have identified possible associations between PPI use and gut microbiota, sug gesting that PPIs use increases the risk of enteric infections, including Clostridium difficile infection. To investigate gut micro biota in Japanese PPIs users, we conducted 16S metagenomics analysis of fecal samples collected from PPI users and healthy adults. In total, 36 PPI users and 36 PPI nonusers (as control sub jects) matched by age and sex were recruited and fecal samples were obtained to analyze the gut microbiome using 16S rRNA gene sequencing. There were significant differences in the micro bial structure between PPI nonusers and PPI users. In contrast, the analysis of αdiversity revealed no significant differences between PPI nonusers and PPI users. When comparing in genus level between these two groups, the genera Streptococcus was significantly abundant and the genera Faecalibacterium was sig nificantly decreased in PPI users. Our findings indicate a probable association between PPI use and the alternation of microbiota. These alterations might provide a mechanism by which PPIs pre dispose enteric infection such as Clostridium difficile infection.