ArticleAmerican journal of physiology. Gastrointestinal and liver physiology2014
Systems biology analysis of omeprazole therapy in cirrhosis demonstrates significant shifts in gut microbiota composition and function.
Article in American journal of physiology. Gastrointestinal and liver physiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01458990 (Proton Pump Inhibitors and Dysbiosis in Cirrhosis), which is not on this map. Cited by 70 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Proton Pump Inhibitors and Dysbiosis in Cirrhosis
Who cites it
70 citing papers in PubMed, 3 syntheses or guidelines pooled it, 139 citations in OpenAlex.
- Proton pump inhibitor use and mortality in patients with cirrhosis: a meta-analysis of cohort studies.Bioscience reports · 2020Pooled it
- Proton pump inhibitor use increases hepatic encephalopathy risk: A systematic review and meta-analysis.World journal of gastroenterology · 2019Pooled it
- Association of proton pump inhibitors with risk of hepatic encephalopathy in advanced liver disease: A meta-analysis.World journal of gastroenterology · 2019Pooled it
- Fecal Microbial Transplant Capsules Are Safe in Hepatic Encephalopathy: A Phase 1, Randomized, Placebo-Controlled Trial.Hepatology (Baltimore, Md.) · 2019Trial
- Trial
- Fecal microbiota transplant from a rational stool donor improves hepatic encephalopathy: A randomized clinical trial.Hepatology (Baltimore, Md.) · 2017Trial
- Non-absorbable antibiotics worsen alcohol-associated liver disease in gastric acid-suppressed mice.Gut microbes · 2026Article
- Review
- Proton pump inhibitors reduce nivolumab efficacy in unresectable advanced or recurrent gastric cancer.Immunotherapy · 2025Article
- Understanding dysbiosis and resilience in the human gut microbiome: biomarkers, interventions, and challenges.Frontiers in microbiology · 2025Review
- Gut Microbiome Changes After Neoadjuvant Chemotherapy and Surgery in Patients with Gastric Cancer.Cancers · 2024Article
- Proton Pump Inhibitors in Patients with Cirrhosis: Pharmacokinetics, Benefits and Drawbacks.Current gastroenterology reports · 2024Review
- The Use of Proton Pump Inhibitors in Patients with Liver Cirrhosis: Real Life Experience.Journal of clinical medicine · 2024Article
- Changes in the Gastrointestinal Microbiota Induced by Proton Pump Inhibitors-A Review of Findings from Experimental Trials.Microorganisms · 2024Review
- Proton Pump Inhibitor Use and Complications of Cirrhosis Are Linked With Distinct Gut Microbial Bacteriophage and Eukaryotic Viral-Like Particle Signatures in Cirrhosis.Clinical and translational gastroenterology · 2024Article
- A Comprehensive Overview of the Past, Current, and Future Randomized Controlled Trials in Hepatic Encephalopathy.Medicina (Kaunas, Lithuania) · 2023Review
- The Intestinal Microbiota in the Development of Chronic Liver Disease: Current Status.Diagnostics (Basel, Switzerland) · 2023Review
- PPI-Induced Changes in Plasma Metabolite Levels Influence Total Hip Bone Mineral Density in a UK Cohort.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2023Article
- The Intratumoral Bacterial Metataxonomic Signature of Hepatocellular Carcinoma.Microbiology spectrum · 2022Article
- Article
10 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors at 5 institutions in 2 countries.
Funding
Abstract
Proton pump inhibitors (PPI) have been associated with infectious complications in cirrhosis, but their impact on distal gut microbiota composition and function is unclear. We aimed to evaluate changes in stool microbiota composition and function in patients with cirrhosis and healthy controls after omeprazole therapy. Both 15 compensated cirrhotic patients and 15 age-matched controls underwent serum gastrin measurement, stool microbiota profiling with multitagged pyrosequencing, and urinary metabolic profiling with NMR spectroscopy to assess microbial cometabolites before/after a 14-day course of 40 mg/day omeprazole under constant diet conditions. Results before (pre) and after PPI were compared in both groups, compared with baseline by systems biology techniques. Adherence was >95% without changes in diet or MELD (model for end-stage liver disease) score during the study. Serum gastrin concentrations significantly increased after PPI in cirrhosis (pre 38.3 ± 35.8 vs. 115.6 ± 79.3 pg/ml P < 0.0001) and controls (pre 29.9 ± 14.5 vs. 116.0 ± 74.0 pg/ml, P = 0.001). A significant microbiota change was seen in both controls and cirrhosis after omeprazole (QIIME P < 0.0001). Relative Streptococcaceae abundance, normally abundant in saliva, significantly increased postomeprazole in controls (1 vs. 5%) and cirrhosis (0 vs. 9%) and was correlated with serum gastrin levels (r = 0.4, P = 0.005). We found significantly reduced hippurate in cirrhosis vs. controls both pre- and postomeprazole and increased lactate in both groups post vs. preomeprazole, whereas dimethylamine (DMA) decreased in cirrhosis only. On correlation network analysis, significant changes in linkages of bacteria with metabolites (hippurate/DMA/lactate) were found postomeprazole, compared with pre-PPI in cirrhosis patients. In conclusion, omeprazole is associated with a microbiota shift and functional change in the distal gut in patients with compensated cirrhosis that could set the stage for bacterial overgrowth.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.