Proton Pump Inhibitor Pantoprazole Modulates Intestinal Microbiota and Induces TLR4 Signaling and Fibrosis in Mouse Liver

Int J Mol Sci. 2022 Nov 9;23(22):13766. doi: 10.3390/ijms232213766.

Abstract

Proton pump inhibitors (PPIs) are one of the most prescribed drugs around the world. PPIs induce microbiota modulation such as obesity both in humans and in animal models. However, since PPIs can induce microbiota modulation despite the absence of a high-fat diet or weight gain, it is an interesting model to correlate microbiota modulation with the establishment of non-alcoholic fatty liver disease (NAFLD). We investigated the effect of pantoprazole treatment on TLR4 signaling and liver histology in C57BL/6J mice for 60 days, trying to correlate microbiota modulation with some aspects of liver injury. We performed glucose (GTT) and insulin (ITT) tolerance tests, serum lipopolysaccharide (LPS) dosage, liver histology, liver and intestine extraction for Western blot and qPCR. Fecal microbiota were investigated via metagenomics. Chronic treatment with pantoprazole induced microbiota modulation and impaired ileum barrier integrity, without an association with insulin resistance. Furthermore, increased circulating LPS and increased Toll-like receptor 4 (TLR4) and TGFβ downstream signaling may have an important role in the development of the observed liver microvesicular steatosis and fibrosis. Finally, this model of PPI-induced changes in microbiota might be useful to investigate liver microvesicular steatosis and fibrosis.

Keywords: liver steatosis; microbiota; proton pump inhibitors.

MeSH terms

  • Animals
  • Fibrosis
  • Gastrointestinal Microbiome*
  • Humans
  • Lipopolysaccharides / pharmacology
  • Mice
  • Mice, Inbred C57BL
  • Non-alcoholic Fatty Liver Disease* / drug therapy
  • Non-alcoholic Fatty Liver Disease* / etiology
  • Pantoprazole / pharmacology
  • Proton Pump Inhibitors / pharmacology
  • Proton Pump Inhibitors / therapeutic use
  • Toll-Like Receptor 4 / therapeutic use

Substances

  • Toll-Like Receptor 4
  • Pantoprazole
  • Proton Pump Inhibitors
  • Lipopolysaccharides
  • TLR4 protein, human
  • Tlr4 protein, mouse