• Singap Med J · Oct 2019

    Comparative Study

    Effects of proton pump inhibitor on the human gut microbiome profile in multi-ethnic groups in Singapore.

    • Seok Hwee Koo, Jing Deng, Daphne Shih Wen Ang, John Chen Hsiang, Lian Shien Lee, Shafiq Aazmi, Elsa Haniffah Mejia Mohamed, Hong Yang, Siew Yoon Yap, Lay Kek Teh, Mohd Zaki Salleh, LeeEdmund Jon DeoonEJDClinical Trials and Research Unit, Changi General Hospital, Singapore.Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore., and Tiing Leong Ang.
    • Clinical Trials and Research Unit, Changi General Hospital, Singapore.
    • Singap Med J. 2019 Oct 1; 60 (10): 512-521.

    IntroductionThe objectives of this study were to examine the effects of ethnicity, gender and a proton pump inhibitor (PPI), omeprazole, on the human gut microbiome. PPIs are commonly used for the treatment of acid-related disorders. We hypothesised that PPI therapy might perturb microbial communities and alter the gut microbiome.MethodsHealthy subjects of Chinese (n = 12), Malay (n = 12) and Indian (n = 10) ancestry, aged 21-37 years, were enrolled. They provided a baseline stool sample (Day 1) and were then given a course of omeprazole at therapeutic dose (20 mg daily) for seven days. Stool samples were collected again on Day 7 and 14 (one week after stopping omeprazole). Microbial DNA was extracted from the stool samples, followed by polymerase chain reaction, library construction, 16S rRNA sequencing using Illumina MiSeq, and statistical and bioinformatics analyses.ResultsThe findings showed an increase in species richness (p = 0.018) after omeprazole consumption on Day 7, which reverted to baseline on Day 14. There were significant increases in the relative abundance of Streptococcus vestibularis (p = 0.0001) and Veillonella dispar (p = 0.0001) on Day 7, which diminished on Day 14. Faecalibacterium prausnitzii, Sutterella stercoricanis and Bacteroides denticanum were characteristic of Chinese, Malays and Indians, respectively. Lactobacillaceae and Bacteroides xylanisolvens were the signature taxa of male and female subjects, respectively.ConclusionThe study demonstrated alterations in the gut microbiome following omeprazole treatment. This may explain the underlying pathology of increased risk of Clostridium difficile infections associated with omeprazole therapy.Copyright: © Singapore Medical Association.

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