The impact of washed microbiota transplantation on serum gastric function markers: Pepsinogen I, Pepsinogen II, and Gastrin-17

Background and aims: Conventional treatment methods for gastric diseases have problems such as drug resistance and recurrence. This study aims to explore whether a new treatment method - Washed Microbiota Transplantation (WMT) - can improve gastric mucosal health.Methods: The clinical data of patients before and after WMT treatment were collected and analyzed, including serum gastric function markers: gastrin-17 (G-17), pepsinogen I (PGI), pepsinogen II (PGII), and the PGI/PGII ratio (PGR). Inflammatory biomarkers: C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6). Fresh fecal samples were collected at baseline and after WMT treatment and stored at -80 C until analysis. Gut microbiota profiling was performed using 16S rRNA genes sequencing. Gastrointestinal symptom severity as measured by the Gastrointestinal Symptom Rating Scale (GSRS), and health-related quality of life assessed by the SF-36 physical and mental component summaries (PCS and MCS). The safety and tolerability of WMT were also assessed.Results: After WMT treatment, serum G-17 and PGI levels decreased significantly (both P < 0.05), while PGII demonstrated a downward trend. Inflammatory markers CRP and PCT likewise declined; notably, the magnitude of CRP reduction positively correlated with changes in PGI (r > 0.5, P < 0.01). Furthermore, 16S rRNA sequencing revealed a significant increase in gut microbial alpha-diversity following WMT, with Chao1, Shannon, and Simpson indices all significantly elevated after the second treatment course compared with baseline (P < 0.05); the relative abundances of several key genera were significantly altered. In addition, patients exhibited significant improvement in GSRS scores (P < 0.01), and both SF-36 PCS and MCS scores increased markedly compared to baseline (P < 0.01). No serious adverse events were observed during the study period; a minority of patients reported mild, transient bloating or diarrhea.Conclusions: WMT was associated with improvements in gastric mucosal health, gut microbial abundance and diversity, and serum gastric function parameters, accompanied by reduced inflammation, alleviated gastrointestinal symptoms, improved quality of life, and a favorable safety profile.