Impact of oral vancomycin on gut microbiota, bile acid metabolism, and insulin sensitivity

A. Vrieze, C. Out, S. Fuentes Enriquez de Salamanca, L. Jonker, I. Reuling, R.S. Kootte, E. van Nood, F. Holleman, M. Knaapen, J.A. Romijn, M.R. Soeters, E.E. Blaak, G.M. Dallinga-Thie, D. Reijnders, M.T. Ackermans, M.J. Serlie, F.K. Knop, J.J. Holst, C.V. Ley, I.P. KemaE.G. Zoetendal, W.M. de Vos, J.B. Hoekstra, E.S. Stroes, A.K. Groen, M. Nieuwdorp

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Abstract

BACKGROUND: Obesity has been associated with changes in the composition and function of the intestinal microbiota. Modulation of the microbiota by antibiotics also alters bile acid and glucose metabolism in mice. Hence, we hypothesized that short term administration of oral antibiotics in humans would affect fecal microbiota composition and subsequently bile acid and glucose metabolism. METHODS: In this single blinded randomized controlled trial, 20 male obese subjects with metabolic syndrome were randomized to 7 days of amoxicillin 500mg t.i.d. or 7 days of vancomycin 500mg t.i.d. At baseline and after 1 week of therapy, fecal microbiota composition (Human Intestinal Tract Chip phylogenetic microarray), fecal and plasma bile acid concentrations as well as insulin sensitivity (hyperinsulinemic euglycemic clamp using [6,6-2H2]-glucose tracer) were measured. RESULTS: Vancomycin reduced fecal microbial diversity with a decrease of gram-positive bacteria (mainly Firmicutes) and a compensatory increase in gram-negative bacteria (mainly Proteobacteria). Concomitantly, vancomycin decreased fecal secondary bile acids with a simultaneous postprandial increase in primary bile acids in plasma (p
Original languageEnglish
Pages (from-to)824-831
JournalJournal of Hepatology
Volume60
Issue number4
DOIs
Publication statusPublished - 2014

Keywords

  • salt hydrolase activity
  • diet-induced obesity
  • intestinal microbiota
  • energy-expenditure
  • mice
  • resistance
  • adiposity
  • glucagon
  • capacity
  • humans

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    Vrieze, A., Out, C., Fuentes Enriquez de Salamanca, S., Jonker, L., Reuling, I., Kootte, R. S., van Nood, E., Holleman, F., Knaapen, M., Romijn, J. A., Soeters, M. R., Blaak, E. E., Dallinga-Thie, G. M., Reijnders, D., Ackermans, M. T., Serlie, M. J., Knop, F. K., Holst, J. J., Ley, C. V., ... Nieuwdorp, M. (2014). Impact of oral vancomycin on gut microbiota, bile acid metabolism, and insulin sensitivity. Journal of Hepatology, 60(4), 824-831. https://doi.org/10.1016/j.jhep.2013.11.034