The type of study presented is a cross-sectional study that tries to establish and explain the different aspects of bacterial communities in the mucosa of patients with duodenal ulcers and gastric antrum ulcers. The purpose of this study is to identify and compare the bacterial communities in these two environments. Moreover, this is a comparison study, and such studies are usually conducted using the cross-sectional method of research. This research study hypothesizes that there is no significant difference in the mucosal bacteria composition and diversity between the gastric antrum mucosa and duodenal mucosa testing positive for Helicobacter Pylori (Hp).
The methodology of the study involved the endoscopic collection of two mucosa tissue samples from gastric and duodenal patients. The mucosa tissue was collected from a total of 20 patients where two were Hp negative. This was determined after inoculating the samples from the 18 participants. The bacterial growth in the cultured samples was observed, while the other sample was used for genomic extraction and sequencing. Data collected from these procedures were used to analyze bacterial composition and diversity in both environments. Statistical analysis of data was conducted using different statistical tools, including SPSS, Chi-Square, t-test and Fisher’s exact test.
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A Graphical Representation of the Methodology
Firmicutes and Bacteroidetes were found to be predominant in Hp positive duodenal ulcers. The results of the study indicate that there was a higher bacterial diversity in the mucosa of patients with duodenal ulcers in comparison to bacterial diversity in patients with gastric antrum ulcers. Both types of ulcers were found to have predominant bacterial phyla which include Firmicutes, Bacteroidetes, and Proteobacteria. Proteobacteria was found predominantly in the Hp gastric antrum ulcers. There were also different genera types in each of the ulcer, whereby in Hp duodenal ulcer the genera identified were Streptococcus, Veillonella, Porphyromonas, and Neisseria. In the Hp gastric antrum ulcer, Prevotella, Porphyromonas, Psychromonas, and Frankia were found to be more frequent. Finally, the bacterial species identified in both species had no significant difference.
For Hp positive gastric antrum ulcers, the proportion of Helicobacter to other bacterial flora was higher by 40%, while in duodenal ulcers it was only 10%. Generally, biodiversity in the Hp positive gastric ulcers mucosa was found to be lower when compared to Hp duodenal ulcers mucosa which could be as a result of the oncogenesis in the gastric mucosa. Further, gastric ulcers has a longer course than duodenal ulcers, which has a correlational effect with reduced flora in the mucosa. Another factor that could result in the increased bacterial diversity in Hp positive duodenal ulcers is the proximity of the duodenum to the small intestines. Moreover, mucosal cells in the gastric antrum secret gastric acid, and therefore the high PH in this region of the body could result in the inability of the growth of the microbial flora. Duodenum mucosal cells, however, do not secrete gastric acid.
The authors of the article through their findings, therefore, concluded that there is a significant difference between the composition and diversity of the bacterial community in the Hp positive gastric antrum and duodenal mucosa. This, therefore, means that eradication of Hp infection combined with probiotic therapy can effectively maintain the gastric mucosa microbiologic levels, consequently keeping the gastric flora and diversity at its maximum. The floral structure, therefore, has a significant effect on the developing peptic ulcers. Given the high prevalence of peptic ulcers over the last few years, it is imperative for researchers to focus on studies that determine the role of flora in the type of peptic ulcers, as this can aid in the development of more effective clinical therapies.
