The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.
School of Basic Medical Sciences, Key Laboratory of Chinese Medicine Rheumatology of Zhejiang Province, Zhejiang Chinese Medical University, Hangzhou, China.
Clin Rheumatol. 2024 Feb;43(2):603-619. doi: 10.1007/s10067-023-06754-x. Epub 2023 Sep 8.
Evidence of gut microbiota disruption for numerous autoimmune diseases has accumulated. Recently, the relationship between the microbiota and primary Sjögren's disease has been increasingly investigated but has yet to be systematically elucidated. Therefore, a meta-analysis of publications dealing on topic was conducted. Case-control studies comparing primary Sjögren's syndrome patients and healthy controls (HCs) were systematically searched in nine databases from inception to March 1, 2023. The primary result quantitatively evaluated in this meta-analysis was the α-diversity. The secondary results qualitatively extracted and analyzed were the β-diversity and relative abundance. In total, 22 case-control studies covering 915 pSS patients and 2103 HCs were examined. The quantitative analysis revealed a slight reduction in α-diversity in pSS patients compared to HCs, with a lower Shannon-Wiener index (SMD = - 0.46, (- 0.68, - 0.25), p < 0.0001, I = 71%), Chao1 richness estimator (SMD = - 0.59, (- 0.86, - 0.32), p < 0.0001, I = 81%), and ACE index (SMD = - 0.92, (- 1.64, - 0.19), p = 0.01, I = 86%). However, the Simpson index (SMD = 0.01, (- 0.43, 0.46) p = 0.95, I = 86%) was similar in the two groups. The β-diversity significantly differed between pSS patients and HCs. Variations in the abundance of specific microbes and their metabolites and potential functions contribute to the pSS pathogenesis. Notably, the abundance of the phylum Firmicutes decreased, while that of Proteobacteria increased. SCFA-producing microbes including Ruminococcaceae, Lachnospiraceae, Faecalibacterium, Butyricicoccus, and Eubacterium hallii were depleted. In addition to diversity, the abundances of some specific microbes were related to clinical parameters. According to this systematic review and meta-analysis, gut microbiota dysbiosis, including reduced diversity, was associated with proinflammatory bacterium enrichment and anti-inflammatory bacterium depletion in pSS patients. Further research on the relationship between the gut microbiota and pSS is warranted.
大量证据表明，肠道微生物群的紊乱与许多自身免疫性疾病有关。最近，人们越来越关注微生物群与原发性干燥综合征（pSS）之间的关系，但尚未得到系统的阐明。因此，对涉及这一主题的文献进行了荟萃分析。在 2023 年 3 月 1 日之前，从九个数据库中系统地搜索了比较原发性干燥综合征患者和健康对照者（HCs）的病例对照研究。本荟萃分析定量评估的主要结果是 α-多样性。定性提取和分析的次要结果是 β-多样性和相对丰度。共检查了 22 项病例对照研究，涵盖 915 名 pSS 患者和 2103 名 HCs。定量分析显示，与 HCs 相比，pSS 患者的 α-多样性略有下降，Shannon-Wiener 指数较低（SMD = -0.46，[-0.68，-0.25]，p < 0.0001，I = 71%），Chao1 丰富度估计值（SMD = -0.59，[-0.86，-0.32]，p < 0.0001，I = 81%）和 ACE 指数（SMD = -0.92，[-1.64，-0.19]，p = 0.01，I = 86%）。然而，两组之间的 Simpson 指数（SMD = 0.01，[-0.43，0.46]，p = 0.95，I = 86%）相似。pSS 患者和 HCs 之间的 β-多样性有显著差异。特定微生物及其代谢物丰度的变化和潜在功能导致 pSS 的发病机制。值得注意的是，厚壁菌门的丰度减少，而变形菌门的丰度增加。包括 Ruminococcaceae、Lachnospiraceae、Faecalibacterium、Butyricicoccus 和 Eubacterium hallii 在内的产生 SCFA 的微生物减少。除了多样性之外，一些特定微生物的丰度与临床参数有关。根据这项系统评价和荟萃分析，肠道微生物群的紊乱，包括多样性降低，与 pSS 患者中促炎细菌的富集和抗炎细菌的减少有关。有必要进一步研究肠道微生物群与 pSS 的关系。
