DataSheet_1_Short-term and long-term alterations of gastrointestinal microbiota with different H. pylori eradication regimens: A meta-analysis.zip

Background and AimsThe impacts of Helicobacter pylori (H. pylori) eradication on the gastrointestinal microbiota are controversial, and whether the short-term and long-term changes in the gastrointestinal microbiota following different eradication regimens are consistent remains inconclusive. This study aimed to examine the effects of various eradication regimens on the gastrointestinal microflora at follow-up evaluations within 7 days, at 1–3 months, and over 6 months changes in the gastrointestinal microbiota.
Materials and MethodsStudies reported on the PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrails.gov databases before March 2022 were collected. Data analysis and visualization were conducted using Review Manager 5.4.1. The tool of the Cochrane Collaboration to assess the risk of bias was suitable for randomized controlled trials with the Newcastle–Ottawa scale for nonrandomized controlled trials. In addition, the process was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.
ResultsAfter a series of rigorous screenings, a total of 34 articles with 1,204 participants were included for this review analysis. The results showed changes in the gut microflora at the phylum level or the family and genus levels. After metronidazole-containing triple therapy, the number of Enterobacteriaceae increased at 1–3 months follow-up. After Metronidazole-free triple therapy, Actinobacteria decreased significantly, and this trend lasted for more than 6 months. Within 7 days after eradication treatment, the follow-up results showed a decrease in the number of Lactobacillus. After Bismuth-containing quadruple therapy, the changes in Actinobacteria fluctuated with the follow-up time. The changes in Proteobacteria showed a downward trend lasting for 1–3 months after eradication but returned to baseline levels over 6 months after eradication. Subgroup analyses indicated that host age could influence changes in the gut microbiota.
ConclusionDifferent eradication regimens had varied effects on the short-term and long-term abundance of the gastrointestinal microbiota, but the decreasing trend of the microbiota diversity was the same for all regimens at the short-term follow-up. This study summarizes the changes of gut microbiota at different stages after different eradication regimens and hope to provide some references for supplementing probiotics, while further studies is needed to support these findings.
Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42021292726

研究背景与目的：幽门螺杆菌（Helicobacter pylori, H. pylori）根除治疗对胃肠道菌群的影响尚存争议，且不同根除给药方案实施后，胃肠道菌群的短期与长期变化是否具有一致性，目前尚无定论。本研究旨在探讨不同根除给药方案对胃肠道菌群的影响，分别于治疗后7天内、1~3个月及6个月以上的随访节点评估胃肠道菌群的变化情况。

材料与方法：检索2022年3月之前发表于PubMed、Embase、Cochrane图书馆、Web of Science及ClinicalTrails.gov数据库的相关研究。采用Review Manager 5.4.1软件进行数据分析与可视化。偏倚风险评估工具方面，随机对照试验采用Cochrane协作网偏倚风险评估工具，非随机对照试验则采用纽卡斯尔-渥太华量表（Newcastle–Ottawa scale）。本研究严格遵循系统评价与Meta分析优先报告条目（Preferred Reporting Items for Systematic Reviews and Meta-Analyses, PRISMA）进行实施。

研究结果：经一系列严格筛选后，本研究共纳入34篇文献，包含1204名受试者，用于本次综述分析。结果显示，胃肠道菌群在门水平、科水平及属水平均发生显著变化。接受含甲硝唑的三联疗法后，随访1~3个月时肠杆菌科（Enterobacteriaceae）丰度升高。接受不含甲硝唑的三联疗法后，放线菌门（Actinobacteria）丰度显著降低，且该趋势持续至治疗后6个月以上。根除治疗后7天内的随访结果显示，乳杆菌属（Lactobacillus）丰度降低。接受含铋剂的四联疗法后，放线菌门丰度随随访时间推移呈现波动变化。变形菌门（Proteobacteria）丰度在根除治疗后1~3个月内呈下降趋势，但于治疗后6个月以上恢复至基线水平。亚组分析结果表明，宿主年龄可对肠道菌群的变化产生影响。

研究结论：不同根除给药方案对胃肠道菌群的短期及长期丰度具有不同影响，但所有给药方案在短期随访阶段均呈现菌群多样性下降的一致趋势。本研究总结了不同根除给药方案后不同阶段的肠道菌群变化情况，以期为益生菌补充策略提供参考依据，同时上述结论仍需更多后续研究予以验证。

系统评价注册信息：https://www.crd.york.ac.uk/PROSPERO/，注册编号：CRD42021292726