Panelli Simona, Capelli Enrica, Lupo Giuseppe Francesco Damiano, Schiepatti Annalisa, Betti Elena, Sauta Elisabetta, Marini Simone, Bellazzi Riccardo, Vanoli Alessandro, Pasi Annamaria, Cacciatore Rosalia, Bacchi Sara, Balestra Barbara, Pastoris Ornella, Frulloni Luca, Corazza Gino Roberto, Biagi Federico, Ciccocioppo Rachele
Department of Biomedical and Clinical Sciences "L. Sacco", Pediatric Clinical Research Center "Invernizzi", University of Milan, 20122 Milan, Italy.
Laboratory of Immunology and Genetic Analysis, Department of Earth and Environmental Science, University of Pavia, 27100 Pavia, Italy.
J Clin Med. 2020 Apr 13;9(4):1109. doi: 10.3390/jcm9041109.
Growing evidence suggests that an altered microbiota composition contributes to the pathogenesis and clinical features in celiac disease (CD). We performed a comparative analysis of the gut microbiota in adulthood CD to evaluate whether: (i) dysbiosis anticipates mucosal lesions, (ii) gluten-free diet restores eubiosis, (iii) refractory CD has a peculiar microbial signature, and (iv) salivary and fecal communities overlap the mucosal one.
This is a cross-sectional study where a total of 52 CD patients, including 13 active CD, 29 treated CD, 4 refractory CD, and 6 potential CD, were enrolled in a tertiary center together with 31 controls. A 16S rRNA-based amplicon metagenomics approach was applied to determine the microbiota structure and composition of salivary, duodenal mucosa, and stool samples, followed by appropriate bioinformatic analyses.
A reduction of both α- and β-diversity in CD, already evident in the potential form and achieving nadir in refractory CD, was evident. Taxonomically, mucosa displayed a significant abundance of and an expansion of , especially in active patients, while treated celiacs showed an intermediate profile between active disease and controls. The saliva community mirrored the mucosal one better than stool.
Expansion of pathobiontic species anticipates villous atrophy and achieves the maximal divergence from controls in refractory CD. Gluten-free diet results in incomplete recovery. The overlapping results between mucosal and salivary samples indicate the use of saliva as a diagnostic fluid.
越来越多的证据表明，肠道微生物群组成的改变与乳糜泻（CD）的发病机制和临床特征有关。我们对成年CD患者的肠道微生物群进行了比较分析，以评估：（i）生态失调是否先于黏膜病变；（ii）无麸质饮食是否能恢复正常微生物群；（iii）难治性CD是否有独特的微生物特征；（iv）唾液和粪便群落是否与黏膜群落重叠。
这是一项横断面研究，共有52例CD患者，包括13例活动期CD、29例经治疗的CD、4例难治性CD和6例潜在CD患者，在一家三级中心入组，同时纳入31名对照。采用基于16S rRNA的扩增子宏基因组学方法来确定唾液、十二指肠黏膜和粪便样本的微生物群结构和组成，随后进行适当的生物信息学分析。
CD患者的α多样性和β多样性均降低，在潜在形式中就已明显，在难治性CD中达到最低点。从分类学上看，黏膜显示出显著丰富的[具体物种未给出]和[具体物种未给出]的扩张，尤其是在活动期患者中，而经治疗的乳糜泻患者显示出介于活动期疾病和对照之间的中间特征。唾液群落比粪便群落更能反映黏膜群落。
致病共生菌的扩张先于绒毛萎缩，并在难治性CD中与对照达到最大差异。无麸质饮食导致恢复不完全。黏膜和唾液样本之间的重叠结果表明唾液可作为一种诊断液体。
