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Systemic Sclerosis Linked With Altered Gut Microbiome

Systemic Sclerosis Linked With Altered Gut Microbiome

The numbers of Bacteroidetes bacteria in the GI tracts of 2 separate cohorts of patients with systemic sclerosis were significantly reduced when compared with healthy controls.

American patients with systemic sclerosis had more extensive alterations in their intestinal microbiota than those in a Norwegian cohort.

An abundance of Prevotella species was associated with moderate-to-severe GI symptoms in patients with systemic sclerosis. Clostridium species abundance was associated with low GI symptom severity, and Lactobacillus with none-to-mild constipation.

GI symptoms are common in systemic sclerosis, affecting up to 90% of patients. But Elizabeth Volkmann and fellow researchers at UCLA pointed out that very little is known about the pathogenesis of GI dysfunction in patients who have the disease.

GI dysfunction decreases quality of life and is difficult to treat, owing to a lack of understanding of its pathogenesis. Prior studies showed that there are alterations in the normal microbiome of the gut in patients with systemic sclerosis.

The authors sought to compare the specific GI microbiota of patients with and without systemic sclerosis, and compare separate cohorts who were geographically removed, while evaluating their hypothesis that specific microbial genera are associated with GI symptom severity. They presented their findings in a recent British Medical Journal article.

The study

Of 51 subjects enrolled in this prospective cohort study, 17 were healthy controls, 17 were patients with systemic sclerosis at UCLA, and 17 were patients with systemic sclerosis at Oslo University Hospital. Stool samples were taken from all subjects and analyzed.

The results

• The microbial composition of subjects with systemic sclerosis in both the UCLA and Oslo University cohorts differed significantly when compared with healthy controls (R2 0.355, p=0.001, and R2 0.126, p=0.002, respectively).

• Two dominant phyla of bacteria were found in systemic sclerosis subjects’ stool: Bacteroidetes (UCLA, 21.3%; Oslo, 45.0%; controls, 63.2%) and Firmicutes (UCLA, 21.3%; Oslo, 42.8%; controls, 33.0%).

Bacteroidetes numbers were significantly reduced in systemic sclerosis subjects when compared with healthy controls (UCLA, p<0.0001, and Oslo, p=0.009).

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