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Proton Pump Inhibitors Increase the Susceptibility of Mice to Oral Infection with Enteropathogenic Bacteria.

AbstractBACKGROUND AND AIMS:
Proton pump inhibitors (PPIs) are among the most frequently prescribed medications. Side effects including an increased risk of intestinal infections have been reported. It is assumed that PPIs can increase susceptibility to enteropathogens; however, the underlying mechanisms are unknown. Here in this study, we explored whether Lansoprazole (Laz), one of the PPIs, increases the susceptibility to enteropathogens, and further investigated the mechanism of it.
METHODS:
Mice were administered Laz intraperitoneally once daily and orally infected with Citrobacter rodentium (C. rodentium). The establishment of intestinal infection was assessed by histology and inflammatory cytokine expression levels measured by quantitative PCR. To test whether Laz changes the intestinal environment to influence the susceptibility, intestinal pH, microbiota, metabolites and immune cell distributions were evaluated via pH measurement, 16S rRNA gene sequencing, metabolome, and flow cytometry analyses after Laz administration.
RESULTS:
Colitis was induced with less C. rodentium in Laz-treated mice as compared with the controls. We found that increased numbers of C. rodentium could reach the cecum following Laz administration. Laz increased pH in the stomach but not in the intestines. It induced dysbiosis and changed the metabolite content of the small intestine. However, these changes did not lead to alterations of immune cell distribution.
CONCLUSIONS:
Laz raised susceptibility to C. rodentium as increased numbers of the pathogen reach the site of infection. Our results suggest that it was due to increased stomach pH which allowed more peroral enteropathogens to pass the stomach, but not because of changes of intestinal environment.
AuthorsEiichiro Yasutomi, Namiko Hoshi, Soichiro Adachi, Takafumi Otsuka, Lingling Kong, Yuna Ku, Haruka Yamairi, Jun Inoue, Tsukasa Ishida, Daisuke Watanabe, Makoto Ooi, Masaru Yoshida, Tomoya Tsukimi, Shinji Fukuda, Takeshi Azuma
JournalDigestive diseases and sciences (Dig Dis Sci) Vol. 63 Issue 4 Pg. 881-889 (04 2018) ISSN: 1573-2568 [Electronic] United States
PMID29327263 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Proton Pump Inhibitors
  • Lansoprazole
Topics
  • Animals
  • Citrobacter rodentium
  • Colitis (microbiology, pathology)
  • Disease Models, Animal
  • Enterobacteriaceae Infections (etiology, pathology)
  • Lansoprazole (administration & dosage, adverse effects)
  • Male
  • Mice
  • Proton Pump Inhibitors (administration & dosage, adverse effects)

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