肠道菌群失调与 Takayasu 动脉炎主动脉瘤的形成和进展有关。
Gut dysbiosis is associated with aortic aneurysm formation and progression in Takayasu arteritis.
机构信息
Department of Vascular Physiology, National Cerebral and Cardiovascular Center Research Institute, 6-1, Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan.
Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Suita, Japan.
出版信息
Arthritis Res Ther. 2023 Mar 24;25(1):46. doi: 10.1186/s13075-023-03031-9.
BACKGROUND
Takayasu arteritis (TAK) is an autoimmune large vessel vasculitis that affects the aorta and its major branches, eventually leading to the development of aortic aneurysm and vascular stenosis or occlusion. This retrospective and prospective study aimed to investigate whether the gut dysbiosis exists in patients with TAK and to identify specific gut microorganisms related to aortic aneurysm formation/progression in TAK.
METHODS
We analysed the faecal microbiome of 76 patients with TAK and 56 healthy controls (HCs) using 16S ribosomal RNA sequencing. We examined the relationship between the composition of the gut microbiota and clinical parameters.
RESULTS
The patients with TAK showed an altered gut microbiota with a higher abundance of oral-derived bacteria, such as Streptococcus and Campylobacter, regardless of the disease activity, than HCs. This increase was significantly associated with the administration of a proton pump inhibitor used for preventing gastric ulcers in patients treated with aspirin and glucocorticoids. Among patients taking a proton pump inhibitor, Campylobacter was more frequently detected in those who underwent vascular surgeries and endovascular therapy for aortic dilatation than in those who did not. Among the genus of Campylobacter, Campylobacter gracilis in the gut microbiome was significantly associated with clinical events related to aortic aneurysm formation/worsening in patients with TAK. In a prospective analysis, patients with a gut microbiome positive for Campylobacter were significantly more likely to require interventions for aortic dilatation than those who were negative for Campylobacter. Furthermore, patients with TAK who were positive for C. gracilis by polymerase chain reaction showed a tendency to have severe aortic aneurysms.
CONCLUSIONS
A specific increase in oral-derived Campylobacter in the gut may be a novel predictor of aortic aneurysm formation/progression in patients with TAK.
背景
Takayasu 动脉炎（TAK）是一种自身免疫性大血管血管炎，影响主动脉及其主要分支，最终导致主动脉瘤和血管狭窄或闭塞的发展。本回顾性和前瞻性研究旨在探讨 TAK 患者是否存在肠道菌群失调，并确定与 TAK 中主动脉瘤形成/进展相关的特定肠道微生物。
方法
我们使用 16S 核糖体 RNA 测序分析了 76 例 TAK 患者和 56 例健康对照（HC）的粪便微生物组。我们检查了肠道微生物群落组成与临床参数之间的关系。
结果
与 HCs 相比，无论疾病活动如何，TAK 患者的肠道微生物群发生改变，口腔来源的细菌（如链球菌和弯曲杆菌）丰度更高。这种增加与预防阿司匹林和糖皮质激素治疗患者胃溃疡的质子泵抑制剂的使用显著相关。在服用质子泵抑制剂的患者中，与未接受血管手术和血管内治疗的主动脉扩张患者相比，接受血管手术和血管内治疗的患者中更频繁地检测到弯曲杆菌。在弯曲杆菌属中，肠道微生物群中的脆弱弯曲杆菌与 TAK 患者与主动脉瘤形成/恶化相关的临床事件显著相关。在前瞻性分析中，肠道微生物群中存在弯曲杆菌的患者比弯曲杆菌阴性的患者更有可能需要进行主动脉扩张干预。此外，通过聚合酶链反应检测到 TAK 患者存在 C. gracilis 的患者，其严重主动脉瘤的趋势更为明显。
结论
肠道中特定的口腔来源弯曲杆菌的增加可能是 TAK 患者主动脉瘤形成/进展的新型预测因子。
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