Article
Shared and distinct gut microbiome signatures in patients with axial spondyloarthritis and its related immune-mediated diseases
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Published: | September 14, 2021 |
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Introduction: Deep profiling of gut microbiota may reveal new pathways of how SpA and its related diseases are initiated and perpetuated. Our objective is to identify specific gut microbiota signatures for SpA, Crohn’s disease (CD), and acute anterior uveitis (AAU) as a whole, as well as for the individual diseases, relative to controls.
Methods: Patients were recruited with a definite diagnosis of axial SpA, AAU or CD and were compared with controls (patients with back pain and previously ruled out SpA/CD/AAU diagnosis). Fecal samples were collected and microbiota composition was determined by 16S rRNA gene sequencing, followed by computational analysis referencing the SILVA138 database. Nested linear models and likelihood ratio tests were used to assess confounding with respect to patient characteristics, HLA-B27 expression, inflammatory markers, and the presence of other immune-mediated diseases.
Results: A total of 300 patients were recruited for the study: 111 axial SpA, 110 AAU, and 79 CD patients and were compared with 63 control individuals (Table 1 [Tab. 1]).
At the phylum level, patients with axial SpA, AAU and CD contained higher abundances of Proteobacteria, Bacteroidetes and Fusobacteria, and lower abundances of Firmicutes and Actinobacteria compared to the control group. At the genus level, patients (with axial SpA, AAU and CD) displayed a shared gut microbiome signature differing from that of control individuals. Patients samples were strongly depleted in Blautia compared with the control group (Figure 1 [Fig. 1]). By looking at each separate disease phenotype, CD patients differed significantly from the control individuals with respect to many genera. These primarily consisted of depletions in Clostridiales (Roseburia, Coprococcus, Ruminococcaceae), and enrichments of pathogen-harboring genera such as Escherichia-Shigella and Fusobacterium. Axial SpA patients were uniquely enriched in Collinsella and Holdemanella and depleted in Cupriavidus. There were strong taxa associations to the presence of HLA-B27, including enrichment of Asteroleplasma, Coprococcus, Faecalibacterium, Rominococcaceae, Lachnospiraceae NK4A136 and Rikenellaceae.
Conclusion: There is a robust shared taxonomic signature among related immune-mediated diseases, in addition to individual disease phenotype signatures. Patients exhibited a strong depletion in Blautia and an enrichment in Lactobacillus as well as pathogen-harboring genera such as Escherichia-Shigella and Fusobacterium.
Disclosures: none