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IBD patients with uveitis show distinct microbiome signature, suggesting gut-eye axis

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Faazil Kassam

Patients with inflammatory bowel disease who develop uveitis, a common extra-intestinal manifestation of IBD affecting the eye, showed a unique gut microbiome signature compared with IBD patients without uveitis, according to new research presented at the American Uveitis Society Meeting.

Investigators said they believe this is the first study to link the gut microbiome with a disease of the eye, which suggests that the “gut-eye axis” may be an important new area for research.

“Patients with inflammatory bowel disease (IBD) are at risk of developing uveitis, an inflammatory disease of the iris, ciliary body, or choroidal vasculature in the eye,” Faazil Kassam, MD, an ophthalmologist and graduate student at Weill Cornell Graduate School of Medical Sciences, told Healio Gastroenterology and Liver Disease. “To date, very little is known about why some patients develop the ophthalmic complication and some do not. Given the emergence of the microbiome as a potential driver of the development of IBD, we opted to assess if the microbiome may be contributing to the development of uveitis.”

To identify a microbial signature that could predict which IBD patients will develop uveitis, Kassam and colleagues performed a case-control study of 18 IBD patients with uveitis (mean age, 46.8 years; 61% women; 78% with Crohn’s disease) and 34 IBD patients with no extra-intestinal manifestations of the disease (mean age, 44.8 years; 62% women; 76% with Crohn’s disease). They obtained colonic biopsies, analyzed them using standard 16s rRNA sequencing, and compared microbial composition between cases and controls after matching them for age, sex, IBD subtype and biopsy location.

Kassam and colleagues found that IBD patients with uveitis showed a distinct microbial profile, “with notable differences at the family and genus level.”

IBD patients with uveitis showed a notable decrease in the relative abundance of the family Coriobacteriaceae (P = .0007), and an increase in the abundance of Fusobacteriaceae (P = .005) compared with controls.

“If we are able to replicate these findings, this may lay the foundation for gastroenterologists and ophthalmologists to one day use microbiome diagnostics to identify IBD patients earlier who are at risk for uveitis, and also develop a new class of microbiome therapeutics to address inflammatory eye diseases,” Kassam said. – by Adam Leitenberger

Reference:

Kassam F, et al. The role of the gut microbiome in uveitis among patients with inflammatory bowel disease. Presented at: American Uveitis Society Fall Meeting; Nov. 12, 2017; New Orleans.

Disclosures: The authors report no relevant financial disclosures.