Cited by 322Gut microbiota and healthClostridium difficile and Clostridium perfringens researchGastrointestinal motility and disorders

Proton Pump Inhibitors Alter Specific Taxa in the Human Gastrointestinal Microbiome: A Crossover Trial

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Freedberg, Daniel E., Toussaint, Nora C., Chen, Sway P., Ratner, Adam J., Whittier, Susan, Wang, Timothy C., Wang, Harris H., Abrams, Julian A.·2015·Gastroenterology

Abstract

We conducted an open-label crossover trial to test whether proton pump inhibitors (PPIs) affect the gastrointestinal microbiome to facilitate Clostridium difficile infection (CDI). Twelve healthy volunteers each donated 2 baseline fecal samples, 4 weeks apart (at weeks 0 and 4). They then took PPIs for 4 weeks (40 mg omeprazole, twice daily) and fecal samples were collected at week 8. Six individuals took the PPIs for an additional 4 weeks (from week 8 to 12) and fecal samples were collected from all subjects at week 12. Samples were analyzed by 16S ribosomal RNA gene sequencing. We found no significant within-individual difference in microbiome diversity when we compared changes during baseline vs changes on PPIs. There were, however, significant changes during PPI use in taxa associated with CDI (increased Enterococcaceae and Streptococcaceae, decreased Clostridiales) and taxa associated with gastrointestinal bacterial overgrowth (increased Micrococcaceae and Staphylococcaceae). In a functional analysis, there were no changes in bile acids on PPIs, but there was an increase in genes involved in bacterial invasion. These alterations could provide a mechanism by which PPIs predispose to CDI. ClinicalTrials.gov ID NCT01901276.

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Authors
Freedberg, D. E., Toussaint, N. C., Chen, S. P., Ratner, A. J., Whittier, S., Wang, T. C., Wang, H. H., & Abrams, J. A.
Affiliations
  • Columbia University Irving Medical Center (US)
  • New York Genome Center (US)
  • Columbia University (US)
Corresponding author
  • Wang, Harris H.
  • Abrams, Julian A.
Venue
Gastroenterology
Publisher
Elsevier BV
Published
2015-10
Volume
149
Issue
4
Pages
883-885.e9
ISSN
0016-5085 (ISSN-L)
OpenAlex
W2153294515
Cited by
322
References
32
Citations by year
2026: 17 · 2025: 23 · 2024: 29 · 2023: 30 · 2022: 26 · 2021: 36 · 2020: 43 · 2019: 28 · 2018: 30 · 2017: 33 · 2016: 25 · 2015: 2
FWCI
13.02
Type
journal article
Language
en
Open access
Locations
  • Gastroenterology (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (1DP5OD009172-02, KL2 TR000081)
  • Columbia University
  • National Center for Advancing Translational Sciences
  • National Science Foundation (MCB-1453219)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
  • Health Sciences › Medicine › Infectious Diseases › Clostridium difficile and Clostridium perfringens research
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Keywords
proton pump inhibitors, omeprazole, gastrointestinal microbiome, Clostridium difficile infection, microbiota alterations, Enterococcaceae, Streptococcaceae, Clostridiales, Micrococcaceae, Staphylococcaceae, bacterial overgrowth, bile acids
MeSH terms
Bacteria, Drug Administration Schedule, Enterocolitis, Pseudomembranous, Feces, Humans, Intestines, Omeprazole, Risk Factors, Time Factors, Clostridioides difficile, Cross-Over Studies, Ribotyping, Proton Pump Inhibitors, Microbiota, Healthy Volunteers

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