PMID- 38027267
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231201
IS  - 2296-2360 (Print)
IS  - 2296-2360 (Electronic)
IS  - 2296-2360 (Linking)
VI  - 11
DP  - 2023
TI  - Gastroesophageal reflux and PPI exposure alter gut microbiota in very young 
      infants.
PG  - 1254329
LID - 10.3389/fped.2023.1254329 [doi]
LID - 1254329
AB  - IMPORTANCE: Infants with symptomatic Gastroesophageal reflux are treated with 
      pharmacological therapy that includes proton pump inhibitors (PPI) with clinical 
      improvement. The alterations to gut microbiome profiles in comparison to infants 
      without reflux is not known. OBJECTIVE: To determine the effect of PPI therapy on 
      gut bacterial richness, diversity, and proportions of specific taxa in infants 
      when compared to infants not exposed to acid suppressive therapy. DESIGN SETTING 
      AND PARTICIPANTS: This cohort study was conducted at the Stony Brook Hospital in 
      Stony Brook, NY between February 2016, and June 2019. Infants meeting inclusion 
      criteria were enrolled in a consecutive fashion. RESULTS: A total of 76 Infants 
      were recruited and 60 were enrolled in the study, Twenty nine infants met 
      clinical criteria for reflux and were treated with PPI therapy: median [IQR] 
      gestation: 38.0 weeks [34.7-39.6 weeks]; median [IQR] birthweight: 2.95 Kg 
      [2.2-3.4]; 14 [46.7%] male) and 29 infant were healthy controls median [IQR] 
      gestation: 39.1 weeks [38-40 weeks]; median [IQR] birthweight: 3.3 Kg [2.2-3.4]; 
      17 [58.6%] male); 58 stool samples from 58 infants were analyzed. There were 
      differences in Shannon diversity between the reflux and control groups. The 
      reflux group that was exposed to PPI therapy had increased relative abundance of 
      a diverse set of genera belonging to the phylum Firmicutes. On the other hand, 
      the control group microbiota was dominated by Bifidobacterium, and a 
      comparatively lower level of enrichment and abundance of microbial taxa was 
      observed in this group of infants. CONCLUSIONS AND RELEVANCE: We observed 
      significant differences in both alpha- and beta-diversity of the microbiome, when the 
      two groups of infants were compared. The microbiome in the reflux group had more 
      bacterial taxa and the duration of PPIs exposure was clearly associated with the 
      diversity and abundance of gut microbes. These findings suggest that PPI exposure 
      among infants results in early enrichment of the intestinal microbiome.
CI  - (c) 2023 Gathungu, Francis, Chawla, LaComb, Robertson, Askinazi and Frank.
FAU - Francis, Denease
AU  - Francis D
AD  - Department of Pediatrics, Texas Tech University Health Sciences Center El Paso, 
      El Paso, TX, United States.
FAU - Chawla, Anupama
AU  - Chawla A
AD  - Department of Pediatrics, Stony Brook University Hospital, Stony Brook, NY, 
      United States.
FAU - LaComb, Joseph F
AU  - LaComb JF
AD  - Department of Pediatrics, Stony Brook University Hospital, Stony Brook, NY, 
      United States.
FAU - Markarian, Katherine
AU  - Markarian K
AD  - Department of Pediatrics, Stony Brook University Hospital, Stony Brook, NY, 
      United States.
FAU - Robertson, Charles E
AU  - Robertson CE
AD  - Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, 
      CO, United States.
FAU - Frank, Daniel N
AU  - Frank DN
AD  - Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, 
      CO, United States.
FAU - Gathungu, Grace N
AU  - Gathungu GN
AD  - Department of Pediatrics, Stony Brook University Hospital, Stony Brook, NY, 
      United States.
LA  - eng
PT  - Journal Article
DEP - 20231031
PL  - Switzerland
TA  - Front Pediatr
JT  - Frontiers in pediatrics
JID - 101615492
PMC - PMC10651085
OTO - NOTNLM
OT  - dysbiosis
OT  - gastroesophageal reflux
OT  - infants
OT  - microbiome
OT  - proton pump inhibitors
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2023/11/29 18:42
MHDA- 2023/11/29 18:43
PMCR- 2023/10/31
CRDT- 2023/11/29 17:03
PHST- 2023/07/06 00:00 [received]
PHST- 2023/09/12 00:00 [accepted]
PHST- 2023/11/29 18:43 [medline]
PHST- 2023/11/29 18:42 [pubmed]
PHST- 2023/11/29 17:03 [entrez]
PHST- 2023/10/31 00:00 [pmc-release]
AID - 10.3389/fped.2023.1254329 [doi]
PST - epublish
SO  - Front Pediatr. 2023 Oct 31;11:1254329. doi: 10.3389/fped.2023.1254329. 
      eCollection 2023.