Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine (Neurology), University of British Columbia, Vancouver, BC, Canada.
Department of Internal Medicine, University of Manitoba, University of Manitoba IBD Clinical and Research Centre, Winnipeg, MB, Canada; National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada; Department of Laboratory Medicine & Pathobiology, University of Toronto, ON, Canada.
Mult Scler Relat Disord. 2020 Jan;37:101427. doi: 10.1016/j.msard.2019.101427. Epub 2019 Oct 2.
To systematically review and synthesize the literature on the multiple sclerosis (MS) gut microbiota composition as compared to persons without MS.
We systematically searched MEDLINE, EMBASE, and Web of Science databases for relevant published articles (2008-2018).
Of 415 articles identified ten fulfilled criteria. All studies used a case-control design, six sourced participants from the US, two Germany, one Italy, and one Japan. Nine focused exclusively on adults and one on children, totaling 286 MS and 296 control participants. Over 90% of cases had relapsing-remitting MS; disease duration ranged from 10.6 ± 6.5 months to 15.3 ± 8.6 years (mean±SD). Nine studies examined stool and one evaluated duodenal mucosa. Diverse platforms were used to quantify microbes: Illumina MiSeq, Roche 454, microarray, and fluorescence in situ hybridization. None of eight studies reported a significant alpha-diversity differences between cases and controls. Two of seven studies reported a difference in beta-diversity (P ≤ 0.002). At the taxa-level, ≥2 studies observed: lower relative abundance of Prevotella, Faecalibacterium prausnitzii, Bacteroides coprophilus, Bacteroides fragilis, and higher Methanobrevibacter and Akkermansia muciniphila in MS cases versus controls. Exposure to an immunomodulatory drug (IMD), relative to no exposure, was associated with individual taxonomic differences in three of three studies.
Gut microbiota diversity did not differ between MS cases and controls in the majority of studies. However, taxonomic differences were found, with consistent patterns emerging across studies. Longitudinal studies are warranted to elucidate the relationship between IMD exposure and differences in the gut microbiota composition.
系统地回顾和综合文献，比较多发性硬化症（MS）的肠道微生物组组成与无 MS 的人。
我们系统地检索了 MEDLINE、EMBASE 和 Web of Science 数据库中相关的已发表文章（2008-2018 年）。
在 415 篇文章中，有 10 篇符合标准。所有研究均采用病例对照设计，6 项研究的参与者来自美国，2 项来自德国，1 项来自意大利，1 项来自日本。9 项研究仅关注成年人，1 项研究关注儿童，共有 286 名 MS 患者和 296 名对照参与者。超过 90%的病例为复发缓解型 MS；疾病持续时间从 10.6±6.5 个月到 15.3±8.6 年不等（平均值±标准差）。9 项研究检查了粪便，1 项研究检查了十二指肠黏膜。使用不同的平台来定量微生物：Illumina MiSeq、Roche 454、微阵列和荧光原位杂交。在 8 项研究中，没有一项研究报告病例和对照组之间的 alpha 多样性存在显著差异。在 7 项研究中，有两项研究报告了 beta 多样性的差异（P≤0.002）。在分类水平上，≥2 项研究观察到：MS 病例中Prevotella、Faecalibacterium prausnitzii、Bacteroides coprophilus、Bacteroides fragilis 的相对丰度较低，Methanobrevibacter 和 Akkermansia muciniphila 的相对丰度较高。与未暴露于免疫调节药物（IMD）相比，暴露于 IMD 与三项研究中的三个分类学差异相关。
在大多数研究中，MS 病例和对照组的肠道微生物多样性没有差异。然而，研究发现了分类学上的差异，研究结果一致。需要进行纵向研究，以阐明 IMD 暴露与肠道微生物组成差异之间的关系。
