Patients with axial spondyloarthritis exhibit shared microbiome dysbiosis
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Key takeaways:
- Certain microbiome factors may predict axial spondyloarthritis and other related inflammatory diseases.
- The researchers stated that additional work is needed to validate their findings.
Patients with axial spondyloarthritis and other related inflammatory diseases demonstrate common microbiome dysfunction characteristics, according to data published in Arthritis & Rheumatology.
“A dysbiotic microbiota composition is broadly defined as an imbalance between symbionts and pathobionts, which reduces the resistance and resilience of the microbial gut ecosystem,” Morgan Essex, MSc, of Charité-Berlin University Medicine, and colleagues wrote. “In a persistent dysbiotic state, physiological conditions such as epithelial barrier integrity may become compromised and increase intestinal permeability. This ‘leaky gut’ phenomenon is thought to drive the inflammation characteristic of several immune-mediated diseases.”
To assess the shared gut microbiota characteristics of patients with axial SpA, Crohn’s disease and acute anterior uveitis, Essex and colleagues performed rRNA sequencing on stool samples from adults aged 18 years or older enrolled in the German Spondyloarthritis Inception Cohort. The researchers collected stool samples, demographic data and blood samples. Inclusion criteria required participants to be naïve to biologic disease-modifying antirheumatic drugs for 3 or more months before enrollment. In addition, they could not have received any kind of antibiotics for 1 month prior to providing a stool sample.
Samples were stored at temperatures to maintain integrity. The researchers isolated the DNA from the samples, with each amplified for analysis. Any samples that did not meet the inclusion criteria or quality control measures were excluded.
The analysis included samples from 277 patients — 102 with axial SpA, 103 with acute anterior uveitis and 72 with Crohn’s disease — and 62 control participants with back pain but no inflammatory diagnosis. According to the researchers, there was a shared, immune-mediated disease signal among patients with axial SpA, acute anterior uveitis and Crohn’s disease, manifesting as “low abundancies” of Lachnospiraceae taxa — especially Fusicatenibacter — compared with control participants. Fusicatenibacter was most commonly abundant in control individuals treated with NSAID monotherapy.
Patients with axial SpA demonstrated an increase of Collinsella, and those with Crohn’s disease had “abundancies” of a Ruminococcus taxon, the researchers wrote. Meanwhile, previous therapy with conventional synthetic DMARDs was associated with increased Akkermansia.
“[Crohn’s disease (CD)], [acute anterior uveitis (AAU)] and SpA share an established epidemiology, yet the pathophysiology underlying their concomitance remains unclear,” Essex and colleagues wrote. “We analyzed a large human cohort comprising all three diseases, and deeply explored the taxonomic composition of the gut microbiota with clinical covariates and disease concomitance for the first time. Our results showed a shared depletion of predominately Lachnospiraceae taxa, most notably Fusicatenibacter, which partially mediated increased [C-reactive protein] and was most abundant in controls receiving NSAID monotherapy.
“Here we presented the baseline cross-section of a prospective cohort examining SpA, CD and AAU,” they added. “Taken together, our results suggest there is much more to be uncovered about the immunomodulatory properties of certain bacteria in these epidemiologically related pathologies, especially at the molecular level, in order to eventually leverage the diagnostic and therapeutic potential of the microbiome.“
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