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Abstract

Korean fermented kimchi is probiotic food preventing Helicobacter pylori (H. pylori)-associated atrophic gastritis in both animal and human trial. In order to reveal the effect of fermented kimchi against H. pylori infection, we performed clinical trial to document the changes of fecal microbiota in 32 volunteers (H. pylori (-) chronic superficial gastritis (CSG), H. pylori (+) CSG, and H. pylori (+) chronic atrophic gastritis (CAG) with 10 weeks kimchi. Each amplicon is sequenced on MiSeq of Illumina and the sequence reads were clustered into operational taxonomic units using VSEARCH and the Chao, Simpson, and Shannon Indices. Though significant difference in α- or β-diversity was not seen in three groups, kimchi intake led to significant diversity of fecal microbiome. As results, Klebsiella, Enterococcus, Ruminococcaceae, Streptococcus, Roseburia, and Clostirdiumsensu were significantly increased in H. pylori (+) CAG, while Akkermansia, Citrobacter, and Lactobacillus were significantly decreased in H. pylori (+) CAG. With 10 weeks of kimchi administration, Bifidobacterium, Lactobacillus, and Ruminococcus were significantly increased in H. pylori (+) CAG, whereas Bacteroides, Subdoligranulum, and Eubacterium coprostanolines were significantly decreased in H. pylori (-) CAG. 10 weeks of kimchi intake significantly improved pepsinogen I/II ratio (p<0.01) with significant decreases in interleukin-1β. Conclusively, fermented kimchi significantly changed fecal microbiota to mitigate H. pylori-associated atrophic gastritis.

Keywords: H. pylori; chronic atrophic gastritis; fecal microbiota; fermented kimchi; pepsinogen I/II ratio.

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Conflict of interest statement

No potential conflicts of interest were disclosed.

Figures

Fig. 1.

Fig. 1.

Clinical trial with fermented kimchi…

Fig. 1.

Clinical trial with fermented kimchi in patients with gastritis. (A) Representative gastroscopic pictures…

Fig. 1. Clinical trial with fermented kimchi in patients with gastritis. (A) Representative gastroscopic pictures showing H. pylori-(−) chronic superficial gastritis (CSG), 10 patients, Male:Female = 5:5, mean ages, 44 ± 5, who was negative in H. pylori infection assessed with CLO (−), UBT (−), and Giemsa staining (−), H. pylori (+) CSG, mild to moderate, in 11 patients, Male:Female = 6:5, mean ages, 48 ± 6, who was positive in H. pylori infection assessed with CLO (+), UBT (+), and Giemsa staining (+), and H. pylori (+) chronic atrophic gastritis (CAG), moderate to severe by Updated Sydney System, in 9 patients, Male:Female = 5:4, mean ages, 51 ± 3, who was positive in H. pylori infection assessed with CLO (+), UBT (+), documentation of presence of H. pylori through Giemsa staining scored according to Updated Sydney System score. (B) Representative gastroscopic pictures showing H. pylori (+) CAG in 9 patients, Male:Female = 4:5, mean ages, 54 ± 4. (C) Schematic protocol for fecal microbiota measurement. All volunteers were administered with fermented kimchi (CJ Food, Suwon, Korea), 100 g/day for 10 weeks. All the volunteers were included after informed consent and their compliance for kimchi intake were more than 95%. Before starting, all were performed CLO/UBT/Giemsa staining and stool/blood collection for microbiota and serology analysis.
Fig. 2.

Fig. 2.

Relative abundance of the phylum…

Fig. 2.

Relative abundance of the phylum level (% similarity) in collected feces samples by…

Fig. 2. Relative abundance of the phylum level (% similarity) in collected feces samples by pyrosequencing. (A) α-Diversity in H. pylori (−) CSG, H. pylori (+) CSG, mild to moderate, and H. pylori (+) CAG, moderate to severe degree. (B) Microbiota at phylum levels, Heatmap and bar display. (C) Microbiota at phylum levels. (D) Relative abundance of the genus level (% similarity) in collected feces samples by pyrosequencing. Significant changes in microbiota among H. pylori (−) CSG, H. pylori (+) CSG, and H. pylori (+) CAG, all before kimchi intake.
Fig. 3.

Fig. 3.

Individual microbiota changes according to…

Fig. 3.

Individual microbiota changes according to gastric pathology and H. pylori status.

Fig. 3. Individual microbiota changes according to gastric pathology and H. pylori status.
Fig. 4.

Fig. 4.

α-Diversity, phylum and genus level…

Fig. 4.

α-Diversity, phylum and genus level analysis after 10 weeks kimchi intake. (A) α-Diversity…

Fig. 4. α-Diversity, phylum and genus level analysis after 10 weeks kimchi intake. (A) α-Diversity in H. pylori (−) CSG and H. pylori (−) CSG with 10 weeks of kimchi intake, (B) α-diversity in H. pylori (+) CSG and H. pylori (+) CSG with 10 weeks of kimchi intake, (C) α-diversity in H. pylori (+) CAG and H. pylori (+) CAG with 10 weeks of kimchi intake.
Fig. 5.

Fig. 5.

(A) α-Diversity in H. pylori …

Fig. 5.

(A) α-Diversity in H. pylori (−) CSG, H. pylori (+) CSG, and H.…

Fig. 5. (A) α-Diversity in H. pylori (−) CSG, H. pylori (+) CSG, and H. pylori (+) CAG with 10 weeks of kimchi intake, respectively. (B, C) Significant changes in microbiota among H. pylori (−) CSG, H. pylori (+), and H. pylori (+) CAG with 10 weeks kimchi intake. (B) Phyllum level analysis; Phylum levels bar analysis (right). (C) Genus levels analysis; Heatmap analysis (left) and genus levels bar analysis (right).
Fig. 6.

Fig. 6.

Significant microbiota changes according to…

Fig. 6.

Significant microbiota changes according to group, (A) between H. pylori (+) CSG and …

Fig. 6. Significant microbiota changes according to group, (A) between H. pylori (+) CSG and H. pylori (+) CSG with 10 weeks of fermented kimchi, (B) between H. pylori (+) CAG and H. pylori (+) CAG with 10 weeks of fermented kimchi.
Fig. 7.

Fig. 7.

Schematic drawing explaining the significant…

Fig. 7.

Schematic drawing explaining the significant contribution of fermented kimchi in either inhibition of …

Fig. 7. Schematic drawing explaining the significant contribution of fermented kimchi in either inhibition of H. pylori (+) CSG and blocking the advancement from H. pylori (+) CSG and H. pylori (+) CAG. Red dot; H. pylori (−) CSG, Blue dot; H. pylori (+) CSG, Green dot; H. pylori (+) CAG after 10 weeks of fermented kimchi intake. Fold changes (log2).
All figures (7) See this image and copyright information in PMC

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