Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL.
Francis I. Proctor Foundation, University of California, San Francisco, CA.
Cornea. 2023 Nov 1;42(11):1340-1348. doi: 10.1097/ICO.0000000000003195. Epub 2022 Dec 10.
Gut microbiome alterations have been associated with various autoimmune diseases. There are limited data, however, on relationships between gut dysbiosis and immune-related dry eye (DE). Our aim was to compare the gut microbiome composition of individuals with early and late markers of Sjögren syndrome (SS) with controls without DE.
We compared 20 individuals with positive early markers [antisalivary protein 1 (SP1), antiparotid secretory protein (PSP), anticarbonic anhydrase 6 (CA6) IgG, IgA, and IgM, n = 19)], or late markers (anti-Ro/SS-A and anti-La/SS-B, n = 1) of SS with no comorbid autoimmune diagnoses and 20 age-matched and sex-matched controls. Collected stool samples underwent deep RNA sequencing. The main outcomes measured included gut microbiome composition and diversity.
A total of 20 cases [Dry Eye Questionnaire-5 15.2 ± 3.4, Ocular Surface Disease Index 55.1 ± 22.8, and Schirmer 7.1 ± 5.2 mm] were compared with 20 controls (Dry Eye Questionnaire-5 4.8 ± 3.8, Ocular Surface Disease Index 14.2 ± 12.3, and Schirmer 20.4 ± 9.2 mm). No differences were observed in α-diversity ( P = 0.97) or overall community structure ( P = 0.62). Between groups, 32 species were differentially abundant ( P < 0.01). Among cases, 27 were relatively more abundant, including 10 Lactobacillus and 4 Bifidobacterium species. A relative depletion of 5 species was found in cases compared with controls, notably Fusobacterium varium and Prevotella stercorea .
Differences in gut microbiome composition were found in individuals with mostly early markers of SS compared with controls. However, their clinical significance to DE manifestations remains unclear. Further studies are needed to elucidate the role of gut dysbiosis on immune dysregulation and disease activity in the various forms of immune-mediated DE.
肠道微生物群的改变与各种自身免疫性疾病有关。然而，关于肠道菌群失调与免疫相关干眼症（DE）之间的关系的数据有限。我们的目的是比较有早期和晚期干燥综合征（SS）标志物的个体与无 DE 的对照者的肠道微生物组组成。
我们比较了 20 名具有阳性早期标志物的个体[抗唾液蛋白 1（SP1）、抗腮腺分泌蛋白（PSP）、抗碳酸酐酶 6（CA6）IgG、IgA 和 IgM，n = 19]或晚期标志物（抗 Ro/SS-A 和抗 La/SS-B，n = 1）的 SS 患者与无合并自身免疫性疾病诊断的 20 名年龄和性别匹配的对照者。收集的粪便样本进行深度 RNA 测序。主要测量的结果包括肠道微生物组组成和多样性。
总共 20 例[干眼问卷-5 15.2 ± 3.4、眼表面疾病指数 55.1 ± 22.8 和 Schirmer 7.1 ± 5.2 mm]与 20 例对照者（干眼问卷-5 4.8 ± 3.8、眼表面疾病指数 14.2 ± 12.3 和 Schirmer 20.4 ± 9.2 mm）进行了比较。在 α-多样性（P = 0.97）或整体群落结构（P = 0.62）方面均无差异。在组间，有 32 种物种差异丰富（P < 0.01）。在病例中，有 27 种相对丰富，包括 10 种乳杆菌和 4 种双歧杆菌。与对照组相比，病例中发现有 5 种物种相对减少，特别是 Fusobacterium varium 和 Prevotella stercorea。
与对照组相比，大多数具有 SS 早期标志物的个体肠道微生物组组成存在差异。然而，其对 DE 表现的临床意义尚不清楚。需要进一步的研究来阐明肠道菌群失调对各种形式的免疫介导的 DE 免疫失调和疾病活动的作用。
