Alternation of the oral, gastric and stool microbiome in patients with reflux esophagitis and Barrett's esophagus

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BACKGROUND: The imbalance of human microbiota has been associated with various inflammatory disease. Compared to intestinal flora, the esophageal microbiome has been understudied,and it remains unclear whether dysbiosis is related to reflux esophagitis (RE) and Barrett's esophagus (BE).This study aimed to synthesize findings on microbial composition changes across different regions of the gastrointestinal tract and their relationship with chronic esophageal reflux diseases. METHODS: We recruited 29 RE patients (10 Grade A; 10 Grade B; 9 Grade C), 9 BE patients, and 10 healthy volunteers to study microbial composition in saliva, gastric juice, and stool using 16S rRNA gene pyrosequencing and analyzed serum inflammatory cytokines using ELISA. RESULTS: Microbiota alpha diversity exhibited no significant changes between groups. In terms of taxonomy, RE and BE patients had more gram-negative anaerobic bacteria in salivary microbiota. Notably, increased Tannerellaceae abundance correlated with elevated serum IL-6 levels, which have been linked to chronic inflammation. Helicobacter was more abundant in gastric fluid of controls. Stool analysis revealed BE patients had higher abundance of phylum Bacteroidetes, and the genus Prevotella, while Fusobacterium was more prevalent in controls. CONCLUSIONS: The increased abundance of Tannerellaceae in saliva was correlated with elevated serum IL-6 levels and may be a contributing factor in chronic esophageal reflux disease. BE patients had a higher abundance of Prevotella, a gram-negative bacterium, which may be linked to early stage esophageal inflammation in chronic reflux disease. Conversely, the increased abundance of Helicobacter in gastric juice may serve as a protective factor.

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