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위축성 위염, 장상피화생에서 위 내 미생물무리의 변화

Alternations of Gastric Microbiota with Mucosal Atrophy and Intestinal Metaplasia

신철민,
소속 상세정보
신철민 ( Shin Cheol-Min ) - Seoul National University Bundang Hospital Department of Internal Medicine

Abstract


Atrophic gastritis (AG) and intestinal metaplasia (IM) are regarded as precancerous lesions of gastric cancer. Helicobacter pylori (H. pylori) infection is a major cause of AG and IM. Although stomach is a hostile environment for most bacteria, increased microbial diversity with the predominance of Proteobacteria and Actinobacteria is frequently observed in H. pylori-uninfected healthy stomach; however, dysbiosis with H. pylori predominance occurs in individuals with H. pylori-associated active chronic gastritis. H. pylori disappear in cases of severe AG and IM or in an environment with high intragastric pH, and consequently, the microbial diversity increases; however, the bacterial composition of these patients differs from that of the individuals with no history of H. pylori infection. According to previous studies, the relative abundance of Firmicutes, such as Streptococcus, Lactobacillus, and Lactococcus, was increased with mucosal atrophy and metaplasia. Oral cavity flora, such as Fusobacterium and Veillonella as well as nitrosating or nitrate-reducing bacteria, other than H. pylori could increase in individuals with severe AG and IM. Alternations of the gastric microbiota following mucosal atrophy and metaplasia may play a pivotal role in gastric carcinogenesis. Nevertheless, more well-designed studies with larger sample size focusing on the gastric mucosa-associated microbial profiles of H. pylori-negative healthy gastric mucosa, H. pylori-infected gastritis, AG, IM with or without H. pylori, and gastric cancer are necessary in the future.

키워드

Helicobacter pylori; Gastritis, atrophic; Intestinal metaplasia; Microbiota

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