PMID- 32412673 OWN - NLM STAT- MEDLINE DCOM- 20201022 LR - 20201022 IS - 1365-2036 (Electronic) IS - 0269-2813 (Linking) VI - 52 IP - 1 DP - 2020 Jul TI - Duodenal bacterial load as determined by quantitative polymerase chain reaction in asymptomatic controls, functional gastrointestinal disorders and inflammatory bowel disease. PG - 155-167 LID - 10.1111/apt.15786 [doi] AB - BACKGROUND: Small intestinal bacterial overgrowth may play a role in gastrointestinal and non-gastrointestinal diseases. AIMS: To use quantitative polymerase chain reaction (qPCR) to determine and compare bacterial loads of duodenal biopsies in asymptomatic controls, and patients with functional gastrointestinal disorders (FGIDs) and inflammatory bowel disease (IBD) including ulcerative colitis (UC) and Crohn's disease (CD). To define effects of gastric acid inhibition on bacterial load, explore links of bacterial load and gastrointestinal symptoms in response to a standardised nutrient challenge and compare bacterial load with glucose breath test results. METHODS: In 237 patients (63 controls, 84 FGID and 90 IBD), we collected mucosal samples under aseptic conditions during endoscopy extracted and total DNA. Bacterial load metric was calculated utilising qPCR measurements of the bacterial 16S rRNA gene, normalised to human beta-actin expression. Standard glucose breath test and nutrient challenge test were performed. RESULTS: The duodenal microbial load was higher in patients with FGID (0.22 +/- 0.03) than controls (0.07 +/- 0.05; P = 0.007) and patients with UC (0.01 +/- 0.05) or CD (0.02 +/- 0.09), (P = 0.0001). While patients treated with proton pump inhibitors (PPI) had significantly higher bacterial loads than non-users (P < 0.05), this did not explain differences between patient groups and controls. Bacterial load was significantly (r = 0.21, P < 0.016) associated with the symptom response to standardised nutrient challenge test. Methane, but not hydrogen values on glucose breath test were associated with bacterial load measured utilising qPCR. CONCLUSIONS: Utilising qPCR, a diagnosis of FGID and treatment with PPI were independently associated with increased bacterial loads. Increased bacterial loads are associated with an augmented symptom response to a standardised nutrient challenge. CI - (c) 2020 John Wiley & Sons Ltd. FAU - Shah, Ayesha AU - Shah A AUID- ORCID: 0000-0003-0710-1691 AD - Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Qld, Australia. AD - Faculty of Medicine and Faulty of Health and Behavioural Sciences, University of Queensland, Brisbane, Qld, Australia. FAU - Talley, Nicholas J AU - Talley NJ AD - Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia. FAU - Koloski, Natasha AU - Koloski N AUID- ORCID: 0000-0002-8647-5933 AD - Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Qld, Australia. AD - Faculty of Medicine and Faulty of Health and Behavioural Sciences, University of Queensland, Brisbane, Qld, Australia. FAU - Macdonald, Graeme A AU - Macdonald GA AD - Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Qld, Australia. AD - Faculty of Medicine and Faulty of Health and Behavioural Sciences, University of Queensland, Brisbane, Qld, Australia. FAU - Kendall, Bradley J AU - Kendall BJ AD - Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Qld, Australia. AD - Faculty of Medicine and Faulty of Health and Behavioural Sciences, University of Queensland, Brisbane, Qld, Australia. FAU - Shanahan, Erin R AU - Shanahan ER AD - Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Qld, Australia. AD - Faculty of Medicine and Faulty of Health and Behavioural Sciences, University of Queensland, Brisbane, Qld, Australia. FAU - Walker, Marjorie M AU - Walker MM AUID- ORCID: 0000-0002-7788-0056 AD - Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia. FAU - Keely, Simon AU - Keely S AD - Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia. FAU - Jones, Michael P AU - Jones MP AD - Psychology Department, Macquarie University, Ryde, NSW, Australia. FAU - Morrison, Mark AU - Morrison M AUID- ORCID: 0000-0001-9257-9133 AD - Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Qld, Australia. AD - Diamantina Institute, University of Queensland, Brisbane, Qld, Australia. FAU - Holtmann, Gerald J AU - Holtmann GJ AUID- ORCID: 0000-0002-0206-2358 AD - Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Qld, Australia. AD - Faculty of Medicine and Faulty of Health and Behavioural Sciences, University of Queensland, Brisbane, Qld, Australia. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20200515 PL - England TA - Aliment Pharmacol Ther JT - Alimentary pharmacology & therapeutics JID - 8707234 RN - 0 (RNA, Ribosomal, 16S) RN - IY9XDZ35W2 (Glucose) SB - IM MH - Adult MH - Aged MH - Bacteria/genetics/isolation & purification MH - Bacterial Load MH - Biopsy MH - Breath Tests/methods MH - Duodenum/*microbiology MH - Female MH - Gastrointestinal Diseases/metabolism/*microbiology MH - Glucose/metabolism MH - Humans MH - Inflammatory Bowel Diseases/metabolism/*microbiology MH - Male MH - Middle Aged MH - Polymerase Chain Reaction/methods MH - RNA, Ribosomal, 16S/genetics EDAT- 2020/05/16 06:00 MHDA- 2020/10/23 06:00 CRDT- 2020/05/16 06:00 PHST- 2020/01/05 00:00 [received] PHST- 2020/02/12 00:00 [revised] PHST- 2020/04/20 00:00 [accepted] PHST- 2020/05/16 06:00 [pubmed] PHST- 2020/10/23 06:00 [medline] PHST- 2020/05/16 06:00 [entrez] AID - 10.1111/apt.15786 [doi] PST - ppublish SO - Aliment Pharmacol Ther. 2020 Jul;52(1):155-167. doi: 10.1111/apt.15786. Epub 2020 May 15.