Advanced

Intestinal dysbiosis is common in systemic sclerosis and associated with gastrointestinal and extraintestinal features of disease

Andréasson, Kristofer LU ; Alrawi, Zaid; Persson, Anita; Jönsson, Göran and Marsal, Jan LU (2016) In Arthritis Research and Therapy 18(1).
Abstract

Background: Recent evidence suggests a link between autoimmunity and the intestinal microbial composition in several rheumatic diseases including systemic sclerosis (SSc). The objective of this study was to investigate the prevalence of intestinal dysbiosis in SSc and to characterise patients suffering from this potentially immunomodulatory deviation. Methods: This study consisted of 98 consecutive patients subject to in-hospital care. Stool samples were analysed for intestinal microbiota composition using a validated genome-based microbiota test (GA-map™ Dysbiosis Test, Genetic Analysis, Oslo, Norway). Gut microbiota dysbiosis was found present as per this standardised test. Patients were examined regarding gastrointestinal and... (More)

Background: Recent evidence suggests a link between autoimmunity and the intestinal microbial composition in several rheumatic diseases including systemic sclerosis (SSc). The objective of this study was to investigate the prevalence of intestinal dysbiosis in SSc and to characterise patients suffering from this potentially immunomodulatory deviation. Methods: This study consisted of 98 consecutive patients subject to in-hospital care. Stool samples were analysed for intestinal microbiota composition using a validated genome-based microbiota test (GA-map™ Dysbiosis Test, Genetic Analysis, Oslo, Norway). Gut microbiota dysbiosis was found present as per this standardised test. Patients were examined regarding gastrointestinal and extraintestinal manifestations of SSc by clinical, laboratory, and radiological measures including esophageal cineradiography, the Malnutrition Universal Screening Tool (MUST), levels of plasma transthyretin (a marker of malnutrition) and faecal (F-) calprotectin (a marker of intestinal inflammation). Results: A majority (75.5%) of the patients exhibited dysbiosis. Dysbiosis was more severe (rs=0.31, p=0.001) and more common (p=0.013) in patients with esophageal dysmotility. Dysbiosis was also more pronounced in patients with abnormal plasma levels of transthyretin (p=0.045) or micronutrient deficiency (p=0.009). In 19 patients at risk for malnutrition according to the MUST, 18 exhibited dysbiosis. Conversely, of the 24 patients with a negative dysbiosis test, only one was at risk for malnutrition. The mean±SEM levels of F-calprotectin were 112±14 and 45±8μg/g in patients with a positive and negative dysbiosis test, respectively. Dysbiosis was more severe in patients with skin telangiectasias (p=0.020), pitting scars (p=0.023), pulmonary fibrosis (p=0.009), and elevated serum markers of inflammation (p<0.001). However, dysbiosis did not correlate with age, disease duration, disease subtype, or extent of skin fibrosis. Conclusions: In this cross-sectional study, intestinal dysbiosis was common in patients with SSc and was associated with gastrointestinal dysfunction, malnutrition and with some inflammatory, fibrotic and vascular extraintestinal features of SSc. Further studies are needed to elucidate the potential causal relationship of intestinal microbe-host interaction in this autoimmune disease.

(Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Dysbiosis, Gastrointestinal, Microbiome, Systemic sclerosis
in
Arthritis Research and Therapy
volume
18
issue
1
publisher
BioMed Central
external identifiers
  • scopus:84999274075
  • wos:000388659200001
ISSN
1478-6354
DOI
10.1186/s13075-016-1182-z
language
English
LU publication?
yes
id
3344c84e-32c9-4ae7-a631-946ab5306518
date added to LUP
2016-12-19 08:04:06
date last changed
2017-11-19 04:35:59
@article{3344c84e-32c9-4ae7-a631-946ab5306518,
  abstract     = {<p>Background: Recent evidence suggests a link between autoimmunity and the intestinal microbial composition in several rheumatic diseases including systemic sclerosis (SSc). The objective of this study was to investigate the prevalence of intestinal dysbiosis in SSc and to characterise patients suffering from this potentially immunomodulatory deviation. Methods: This study consisted of 98 consecutive patients subject to in-hospital care. Stool samples were analysed for intestinal microbiota composition using a validated genome-based microbiota test (GA-map™ Dysbiosis Test, Genetic Analysis, Oslo, Norway). Gut microbiota dysbiosis was found present as per this standardised test. Patients were examined regarding gastrointestinal and extraintestinal manifestations of SSc by clinical, laboratory, and radiological measures including esophageal cineradiography, the Malnutrition Universal Screening Tool (MUST), levels of plasma transthyretin (a marker of malnutrition) and faecal (F-) calprotectin (a marker of intestinal inflammation). Results: A majority (75.5%) of the patients exhibited dysbiosis. Dysbiosis was more severe (r<sub>s</sub>=0.31, p=0.001) and more common (p=0.013) in patients with esophageal dysmotility. Dysbiosis was also more pronounced in patients with abnormal plasma levels of transthyretin (p=0.045) or micronutrient deficiency (p=0.009). In 19 patients at risk for malnutrition according to the MUST, 18 exhibited dysbiosis. Conversely, of the 24 patients with a negative dysbiosis test, only one was at risk for malnutrition. The mean±SEM levels of F-calprotectin were 112±14 and 45±8μg/g in patients with a positive and negative dysbiosis test, respectively. Dysbiosis was more severe in patients with skin telangiectasias (p=0.020), pitting scars (p=0.023), pulmonary fibrosis (p=0.009), and elevated serum markers of inflammation (p&lt;0.001). However, dysbiosis did not correlate with age, disease duration, disease subtype, or extent of skin fibrosis. Conclusions: In this cross-sectional study, intestinal dysbiosis was common in patients with SSc and was associated with gastrointestinal dysfunction, malnutrition and with some inflammatory, fibrotic and vascular extraintestinal features of SSc. Further studies are needed to elucidate the potential causal relationship of intestinal microbe-host interaction in this autoimmune disease.</p>},
  articleno    = {278},
  author       = {Andréasson, Kristofer and Alrawi, Zaid and Persson, Anita and Jönsson, Göran and Marsal, Jan},
  issn         = {1478-6354},
  keyword      = {Dysbiosis,Gastrointestinal,Microbiome,Systemic sclerosis},
  language     = {eng},
  month        = {11},
  number       = {1},
  publisher    = {BioMed Central},
  series       = {Arthritis Research and Therapy},
  title        = {Intestinal dysbiosis is common in systemic sclerosis and associated with gastrointestinal and extraintestinal features of disease},
  url          = {http://dx.doi.org/10.1186/s13075-016-1182-z},
  volume       = {18},
  year         = {2016},
}