Proton Pump Inhibitors Alter Specific Taxa in the Human Gastrointestinal Microbiome: A Crossover Trial
Open accessAbstract
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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PPI-driven gastric hypochlorhydria can cause significant changes in gut microbiota composition.
“likely due to PPI-driven gastric hypo-chlorhydria, which can cause also significant changes in gut microbiota composition[9-11]”
From Proton pump inhibitors and dysbiosis: current knowledge and aspects to be clarified (2019) · cites this paper as [10]
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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.
- ORCID
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2015-10
- Volume
- 149
- Issue
- 4
- Pages
- 883-885.e9
- ISSN
- 0016-5085 (ISSN-L)
- PMC
- PMC4584196
- 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
- bronze
- doi.org
- 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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