Top

Published in:

01-09-2014 | Brief Communication

The Effect of PPI Use on Human Gut Microbiota and Weight Loss in Patients Undergoing Laparoscopic Roux-en-Y Gastric Bypass

Authors: Emily K. Ward, Dara P. Schuster, Katie H. Stowers, Amanda K. Royse, Diana Ir, Charles E. Robertson, Daniel N. Frank, Gregory L. Austin

Published in: Obesity Surgery | Issue 9/2014

Abstract

Laparoscopic Roux-en-Y gastric bypass (LRYGB) achieves sustainable weight loss possibly by altering the gut microbiota. The effect of a proton pump inhibitor (PPI) on weight loss and the gut microbiota has not been explored. PPI use and the gut microbiota were assessed before and 6 months after LRYGB in eight patients. Bacterial profiles were generated by 16S ribosomal RNA (rRNA) gene sequencing. Prior to LRYGB, PPI users had a higher percent relative abundance (PRA) of Firmicutes compared to nonusers. PPI users at 6 months post-LRYGB had a higher PRA of Firmicutes [48.6 versus 35.6 %, p = nonsignificant (NS)] and a trend toward significantly lower percent excess weight loss (49.3 versus 61.4 %, p = 0.067) compared to nonusers. PPI use post-LRYGB may impair weight loss by modifying gut microbiota.

Ley RE et al. Obesity alters gut microbial ecology. Proc Natl Acad Sci U S A. 2005;102(31):11070–5.PubMedCentralPubMedCrossRef

Turnbaugh PJ et al. A core gut microbiome in obese and lean twins. Nature. 2009;457(7228):480–4.PubMedCentralPubMedCrossRef

Turnbaugh PJ et al. An obesity-associated gut microbiome with increased capacity for energy harvest. Nature. 2006;444(7122):1027–31.PubMedCrossRef

Jumpertz R et al. Energy-balance studies reveal associations between gut microbes, caloric load, and nutrient absorption in humans. Am J Clin Nutr. 2011;94(1):58–65.PubMedCentralPubMedCrossRef

Buchwald H et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.PubMedCrossRef

Furet JP et al. Differential adaptation of human gut microbiota to bariatric surgery-induced weight loss: links with metabolic and low-grade inflammation markers. Diabetes. 2010;59(12):3049–57.PubMedCentralPubMedCrossRef

Graessler J et al. Metagenomic sequencing of the human gut microbiome before and after bariatric surgery in obese patients with type 2 diabetes: correlation with inflammatory and metabolic parameters. Pharmacogenomics J. 2012;2(10):43.

Liou AP, et al. Conserved shifts in the gut microbiota due to gastric bypass reduce host weight and adiposity. Sci Transl Med., 2013. 5(178): p. 178ra41. doi: 10.1126/scitranslmed.3005687.

Friedenberg FK et al. The association between gastroesophageal reflux disease and obesity. Am J Gastroenterol. 2008;103(8):2111–22.PubMedCrossRef

10.

Yoshikawa I et al. Long-term treatment with proton pump inhibitor is associated with undesired weight gain. World J Gastroenterol. 2009;15(38):4794–8.PubMedCentralPubMedCrossRef

11.

Lo WK, Chan WW. Proton pump inhibitor use and the risk of small intestinal bacterial overgrowth: a meta-analysis. Clin Gastroenterol Hepatol. 2012;24(12):011.

12.

Michalek W, Semler JR, Kuo B. Impact of acid suppression on upper gastrointestinal pH and motility. Dig Dis Sci. 2011;56(6):1735–42.PubMedCrossRef

13.

Hara N et al. Prevention of virus-induced type 1 diabetes with antibiotic therapy. J Immunol. 2012;189(8):3805–14.PubMedCrossRef

14.

Markle JG et al. Sex differences in the gut microbiome drive hormone-dependent regulation of autoimmunity. Science. 2013;339(6132):1084–8.PubMedCrossRef

15.

Ewing B, Green P. Base-calling of automated sequencer traces using phred. II. Error probabilities. Genome Res. 1998;8(3):186–94.PubMedCrossRef

16.

Edgar RC et al. UCHIME improves sensitivity and speed of chimera detection. Bioinformatics. 2011;27(16):2194–200.PubMedCentralPubMedCrossRef

17.

Schloss PD, Westcott SL. Assessing and improving methods used in operational taxonomic unit-based approaches for 16S rRNA gene sequence analysis. Appl Environ Microbiol. 2011;77(10):3219–26.PubMedCentralPubMedCrossRef

18.

Pruesse E, Peplies J, Glockner FO. SINA: accurate high-throughput multiple sequence alignment of ribosomal RNA genes. Bioinformatics. 2012;28(14):1823–9. doi:10.1093/bioinformatics/bts252. Epub 2012 May 3.PubMedCentralPubMedCrossRef

19.

Pruesse E et al. SILVA: a comprehensive online resource for quality checked and aligned ribosomal RNA sequence data compatible with ARB. Nucleic Acids Res. 2007;35(21):7188–96.PubMedCentralPubMedCrossRef

20.

Robertson CE, et al. Explicet: graphical user interface software for metadata-driven management, analysis, and visualization of microbiome data. Bioinformatics. (in press), 2013.

21.

Magurran AE. Measuring biological diversity. Malden, USA: Blackwell; 2004.

22.

Zhang H et al. Human gut microbiota in obesity and after gastric bypass. Proc Natl Acad Sci U S A. 2009;106(7):2365–70.PubMedCentralPubMedCrossRef

23.

Ward EK et al. Acid suppression medications delay peak weight loss after bariatric surgery. Gastroenterology. 2013;144(5, Supplement 1):S-270.

Title: The Effect of PPI Use on Human Gut Microbiota and Weight Loss in Patients Undergoing Laparoscopic Roux-en-Y Gastric Bypass
Authors: Emily K. Ward
Dara P. Schuster
Katie H. Stowers
Amanda K. Royse
Diana Ir
Charles E. Robertson
Daniel N. Frank
Gregory L. Austin
Publication date: 01-09-2014
Publisher: Springer US
Published in: Obesity Surgery / Issue 9/2014
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-014-1275-1

At a glance: The STEP trials

Springer Medicine

The Effect of PPI Use on Human Gut Microbiota and Weight Loss in Patients Undergoing Laparoscopic Roux-en-Y Gastric Bypass

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 9/2014

Laparoscopic Sleeve Gastrectomy Versus Single Anastomosis (Mini-) Gastric Bypass for the Treatment of Type 2 Diabetes Mellitus: 5-Year Results of a Randomized Trial and Study of Incretin Effect

Single Incision Transumbilical Laparoscopic Roux-en-Y Gastric Bypass—Our Technique

Taste, Smell and Appetite Change After Roux-en-Y Gastric Bypass Surgery

Percutaneous Transesophageal Gastro-tubing for Management of Gastric Leakage After Sleeve Gastrectomy

Axis I Disorders in Adjustable Gastric Band Patients: the Relationship Between Psychopathology and Weight Loss

A Meta-analysis of 2-Year Effect After Surgery: Laparoscopic Roux-en-Y Gastric Bypass Versus Laparoscopic Sleeve Gastrectomy for Morbid Obesity and Diabetes Mellitus