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Background <p>Evidence indicates that 3 gas breath testing (BT) correlates with stool microbial populations. Breath methane (CH<sub>4</sub>) levels correlate with stool <i>Methanobrevibacter smithii</i> levels and constipation, while hydrogen sulfide (H<sub>2</sub>S) levels correlate with stool H<sub>2</sub>S producers and diarrhea. However, their relationships to small bowel microbes are unknown.</p> Aims <p>To assess relationships between small bowel microbes and breath gases.</p> Methods <p>REIMAGINE study subjects completed a fasting single-sample BT for CH<sub>4</sub> and H<sub>2</sub>S. During esophagogastroduodenoscopy without colon preparation, duodenal aspirates were obtained using double-lumen sterile aspiration catheters. Microbial DNAs underwent shotgun sequencing (NovaSeq6000).</p> Results <p>Duodenal bacterial profiles differed significantly in subjects with breath H<sub>2</sub>S ≥ 1.5&#xa0;ppm vs. those with &lt; 1.5&#xa0;ppm, with 2.08-log<sub>2</sub>fold greater prevalence of phylum Thermodesulfobacteriota. Higher breath H<sub>2</sub>S levels correlated with greater duodenal prevalences of H<sub>2</sub>S producers, including <i>Proteus mirabilis</i> (<i>P</i> = 0.002), <i>Desulfosarcina widdelii</i> (<i>P</i> = 0.027), and <i>Desulfobulbus oligotrophicus</i> (<i>P</i> = 0.041); co-occurrence of all 3 species correlated with ~ 50% higher breath H<sub>2</sub>S levels (<i>P</i> = 0.0001). Duodenal archaeal profiles differed significantly in subjects with intestinal methanogen overgrowth (IMO, CH<sub>4</sub> ≥ 10&#xa0;ppm), with 2.94-log<sub>2</sub>fold greater prevalence of family Methanobacteriaceae vs. non-IMO&#xa0;subjects. Higher breath CH<sub>4</sub> correlated with greater prevalences of methanogens including <i>M. smithii</i> (<i>P</i> = 0.02), <i>Halarchaeum</i> sp. CBA1220 (<i>P</i> = 0.003), <i>Desulfurococcus mucosus</i> (<i>P</i> = 0.046), and <i>Halobaculum rubrum</i> (<i>P</i> = 0.049). IMO was more common in subjects with co-occurrence of all 4 species (<i>P</i> = 0.04). In IMO-positive subjects, CH<sub>4</sub> levels correlated with greater constipation severity (<i>P</i> = 0.019); <i>P. mirabilis</i> (<i>P</i> = 0.021) and <i>D. oligotrophicus</i> (<i>P</i> = 0.003) correlated with looser stool in IMO-negative subjects. <i>M. smithii</i> prevalence correlated with known hydrogen-producing syntrophs, e.g., <i>Christensenella minuta</i> (<i>P</i> &lt; 0.001).</p> Conclusion <p>This study demonstrates that duodenal prevalences of H<sub>2</sub>S-producing bacteria and methanogenic archaea contribute to H<sub>2</sub>S and CH<sub>4</sub> levels, respectively, on BT.</p>

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Hydrogen Sulfide and Methane on Breath Test Correlate with Human Small Intestinal Hydrogen Sulfide Producers and Methanogens

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月26日

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  • Maria Jesus Villanueva-Millan,
  • Gabriela Leite,
  • Ruchi Mathur,
  • Ali Rezaie,
  • Cristina Moreno Fajardo,
  • Juliana de Freitas Germano,
  • Walter Morales,
  • Maritza Sanchez,
  • Ignacio Rivera,
  • Gonzalo Parodi,
  • Stacy Weitsman,
  • Mohamad Rashid,
  • Ava Hosseini,
  • Daniel Brimberry,
  • Gillian M. Barlow,
  • Mark Pimentel

摘要

Background

Evidence indicates that 3 gas breath testing (BT) correlates with stool microbial populations. Breath methane (CH4) levels correlate with stool Methanobrevibacter smithii levels and constipation, while hydrogen sulfide (H2S) levels correlate with stool H2S producers and diarrhea. However, their relationships to small bowel microbes are unknown.

Aims

To assess relationships between small bowel microbes and breath gases.

Methods

REIMAGINE study subjects completed a fasting single-sample BT for CH4 and H2S. During esophagogastroduodenoscopy without colon preparation, duodenal aspirates were obtained using double-lumen sterile aspiration catheters. Microbial DNAs underwent shotgun sequencing (NovaSeq6000).

Results

Duodenal bacterial profiles differed significantly in subjects with breath H2S ≥ 1.5 ppm vs. those with < 1.5 ppm, with 2.08-log2fold greater prevalence of phylum Thermodesulfobacteriota. Higher breath H2S levels correlated with greater duodenal prevalences of H2S producers, including Proteus mirabilis (P = 0.002), Desulfosarcina widdelii (P = 0.027), and Desulfobulbus oligotrophicus (P = 0.041); co-occurrence of all 3 species correlated with ~ 50% higher breath H2S levels (P = 0.0001). Duodenal archaeal profiles differed significantly in subjects with intestinal methanogen overgrowth (IMO, CH4 ≥ 10 ppm), with 2.94-log2fold greater prevalence of family Methanobacteriaceae vs. non-IMO subjects. Higher breath CH4 correlated with greater prevalences of methanogens including M. smithii (P = 0.02), Halarchaeum sp. CBA1220 (P = 0.003), Desulfurococcus mucosus (P = 0.046), and Halobaculum rubrum (P = 0.049). IMO was more common in subjects with co-occurrence of all 4 species (P = 0.04). In IMO-positive subjects, CH4 levels correlated with greater constipation severity (P = 0.019); P. mirabilis (P = 0.021) and D. oligotrophicus (P = 0.003) correlated with looser stool in IMO-negative subjects. M. smithii prevalence correlated with known hydrogen-producing syntrophs, e.g., Christensenella minuta (P < 0.001).

Conclusion

This study demonstrates that duodenal prevalences of H2S-producing bacteria and methanogenic archaea contribute to H2S and CH4 levels, respectively, on BT.