Finnish Red Cross Blood Service, Helsinki, Finland.
Inflamm Bowel Dis. 2013 Apr;19(5):934-41. doi: 10.1097/MIB.0b013e31828029a9.
Celiac disease is classically manifested in the gastrointestinal (GI) tract but extraintestinal symptoms, such as dermatitis herpetiformis (DH), are also common. Besides several well-known shared genetic risk factors and an environmental trigger, gliadin, factors determining the clinical outcome of the disease are not known. In this study, the role of duodenal microbiota in the celiac disease outcome was studied by analyzing mucosa-associated microbiota in celiac disease patients with a variety of intestinal and extraintestinal symptoms.
Microbiota in duodenal biopsy samples obtained from 33 patients with celiac disease with GI, DH, anemia, or mixed symptoms, as well as screen-detected asymptomatic celiac disease and 18 control subjects were analyzed using PCR denaturing gradient gel electrophoresis and a subset of samples additionally by the 16S ribosomal RNA gene sequencing.
The composition and diversity of mucosal microbiota was associated with the manifestation of celiac disease when analyzed using PCR denaturing gradient gel electrophoresis and the 16S ribosomal RNA gene sequencing. The patients with celiac disease with GI symptoms or anemia had lower microbial diversity than those with DH. Moreover, the patients with GI symptoms had different intestinal microbiota composition and structure, dominated by Proteobacteria, in comparison to those with DH or control subjects (patients with dyspepsia). The relatively similar intestinal microbiota composition in the control subjects and those with DH was characterized by the high abundance of Firmicutes.
The two common outcomes of celiac disease, classical GI and extraintestinal manifestations, had marked differences on the diversity and composition of intestinal microbiota. This association suggested that intestinal microbiota may have a role in the manifestation of the disease.
乳糜泻主要表现为胃肠道（GI）症状，但也存在疱疹样皮炎（DH）等肠外症状。除了一些众所周知的共同遗传风险因素和环境触发因素外，还不知道导致疾病临床结果的其他因素。在这项研究中，通过分析具有各种肠内和肠外症状的乳糜泻患者的黏膜相关微生物群，研究了十二指肠微生物群在乳糜泻疾病结果中的作用。
使用聚合酶链反应变性梯度凝胶电泳和 16S 核糖体 RNA 基因测序分析了 33 例乳糜泻患者（有 GI、DH、贫血或混合症状、筛查无症状乳糜泻患者以及 18 例对照者）的十二指肠活检样本中的微生物群。
当使用 PCR 变性梯度凝胶电泳和 16S 核糖体 RNA 基因测序分析时，黏膜微生物群的组成和多样性与乳糜泻的表现相关。与有 DH 的患者相比，有 GI 症状或贫血的乳糜泻患者的微生物多样性较低。此外，与有 DH 或对照者（消化不良患者）相比，有 GI 症状的患者的肠道微生物群组成和结构存在差异，以变形菌门为主。对照者和有 DH 的患者相对相似的肠道微生物群组成特征为厚壁菌门丰度较高。
乳糜泻的两种常见结果，即经典的 GI 和肠外表现，在肠道微生物群的多样性和组成上存在显著差异。这种关联表明肠道微生物群可能在疾病表现中起作用。
