Effect of a proton-pump inhibitor on intestinal microbiota in patients taking low-dose aspirin

Background and aim Low-dose aspirin (LDA) administration prevents cerebral infarction and myocardial infarction, but many studies found an association with mucosal injury. Proton-pump inhibitors (PPIs) can prevent gastric and duodenal mucosal damage, but they may exacerbate small-intestinal mucosal...

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Vydáno v:	European journal of clinical pharmacology Ročník 77; číslo 11; s. 1639 - 1648
Hlavní autoři:	Tsujimoto, Hiroyuki, Hirata, Yuki, Ueda, Yasuhiro, Kinoshita, Naohiko, Tawa, Hideki, Tanaka, Yasuyoshi, Koshiba, Ryoji, Ota, Kazuhiro, Kojima, Yuichi, Kakimoto, Kazuki, Takeuchi, Toshihisa, Miyazaki, Takako, Nakamura, Shiro, Higuchi, Kazuhide
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	Berlin/Heidelberg Springer Berlin Heidelberg 01.11.2021 Springer Nature B.V
Témata:	Aged Aged, 80 and over Anti-Inflammatory Agents, Non-Steroidal - administration & dosage Aspirin Aspirin - administration & dosage Biomedical and Life Sciences Biomedicine Case-Control Studies Cerebral infarction Clinical Trial Comorbidity Dose-Response Relationship, Drug Esomeprazole - pharmacology Female Gastric juice Gastrin Gastrins - blood Gastrointestinal Hemorrhage - chemically induced Gastrointestinal Microbiome - drug effects Hematocrit Hemoglobin Hemoglobins Humans Intestinal microflora Intestinal Mucosa - drug effects Intestine Lactobacillales - drug effects Male Microbiota Middle Aged Mucosa Myocardial infarction Omeprazole Pharmacology/Toxicology Polymorphism, Restriction Fragment Length Prospective Studies Proton Pump Inhibitors - pharmacology Pyrroles - pharmacology Restriction fragment length polymorphism Sulfonamides - pharmacology Low-dose aspirin Small intestine Intestinal microbiota Mucosal injury Proton-pump inhibitor
ISSN:	0031-6970, 1432-1041, 1432-1041
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Popis
Shrnutí:	Background and aim Low-dose aspirin (LDA) administration prevents cerebral infarction and myocardial infarction, but many studies found an association with mucosal injury. Proton-pump inhibitors (PPIs) can prevent gastric and duodenal mucosal damage, but they may exacerbate small-intestinal mucosal injury by altering the microbiota. We aimed to assess the effect of PPIs on the intestinal flora of LDA users. Methods Thirty-two recruited patients, who received LDA (100 mg/day) but did not take PPIs, were divided into 15 patients additionally receiving esomeprazole (20 mg/day) and 17 patients additionally receiving vonoprazan (10 mg/day). On days 0, 30, 90, and 180, the microbiota of each patient was examined by terminal restriction fragment length polymorphism analysis, and the serum gastrin, hemoglobin, and hematocrit levels were measured. Results Additional PPI administration increased the proportion of Lactobacillales in the microbiota of LDA users. This trend was more prevalent in the vonoprazan group ( p < 0.0001) than in the esomeprazole group ( p = 0.0024). The Lactobacillales proportion was positively correlated with the gastrin level ( r = 0.5354). No significant hemoglobin or hematocrit level reduction was observed in subjects receiving LDA with additional PPI. Conclusions Additional PPI administration increased the Lactobacillales proportion in the microbiota of LDA users. The positive correlation between the gastrin level and the proportion of Lactobacillales suggested that the change in the intestinal flora was associated with the degree of suppression of gastric acid secretion. Additional oral PPI did not significantly promote anemia, but the risk of causing PPI-induced small-intestinal mucosal injury in LDA users should be considered.
Bibliografie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 ObjectType-Undefined-3
ISSN:	0031-6970 1432-1041 1432-1041
DOI:	10.1007/s00228-021-03167-0