Matz Lisa M, Shah Nisarg S, Porterfield Laura, Stuyck Olivia M, Jochum Michael D, Kayed Rakez, Taglialatela Giulio, Urban Randall J, Buffington Shelly A
Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, USA.
Department of Internal Medicine, The University of Texas Medical Branch at Galveston, Galveston, TX, USA.
medRxiv. 2024 Mar 22:2024.03.20.24304637. doi: 10.1101/2024.03.20.24304637.
Type 2 diabetes (T2D) is a common forerunner of neurodegeneration and dementia, including Alzheimer's Disease (AD), yet the underlying mechanisms remain unresolved. Individuals of Mexican descent living in South Texas have increased prevalence of comorbid T2D and early onset AD, despite low incidence of the predisposing APOE-e4 variant and an absence of the phenotype among relatives residing in Mexico - suggesting a role for environmental factors in coincident T2D and AD susceptibility. Here, in a small clinical trial, we show dysbiosis of the human gut microbiome could contribute to neuroinflammation and risk for AD in this population. Divergent Gastrointestinal Symptom Rating Scale (GSRS) responses, despite no differences in expressed dietary preferences, provided the first evidence for altered gut microbial ecology among T2D subjects (sT2D) population-matched healthy controls (HC). Metataxonomic 16S rRNA sequencing of participant stool revealed a decrease in alpha diversity of sT2D HC gut communities and identified BMI as a driver of gut community structure. Linear discriminant analysis effect size (LEfSe) identified a significant decrease in the relative abundance of the short-chain fatty acid-producing taxa , , and and an increase in pathobionts , , and among sT2D gut microbiota, as well as differentially abundant gene and metabolic pathways. These results suggest characterization of the gut microbiome of individuals with T2D could identify key actors among "disease state" microbiota which may increase risk for or accelerate the onset of neurodegeneration. Furthermore, they identify candidate microbiome-targeted approaches for prevention and treatment of neuroinflammation in AD.
2型糖尿病(T2D)是神经退行性疾病和痴呆症(包括阿尔茨海默病(AD))的常见先兆,但其潜在机制仍未明确。生活在南德克萨斯州的墨西哥裔个体中,T2D与早发性AD的合并患病率有所增加,尽管易感的APOE-e4变体发病率较低,且居住在墨西哥的亲属中不存在该表型——这表明环境因素在T2D和AD易感性的同时出现中起作用。在此,在一项小型临床试验中,我们表明人类肠道微生物群的失调可能导致该人群的神经炎症和AD风险。尽管在表达的饮食偏好上没有差异,但不同的胃肠道症状评分量表(GSRS)反应为T2D受试者(sT2D)与人群匹配的健康对照(HC)之间肠道微生物生态改变提供了首个证据。对参与者粪便进行的宏分类16S rRNA测序显示,sT2D与HC肠道群落的α多样性降低,并确定BMI是肠道群落结构的驱动因素。线性判别分析效应大小(LEfSe)确定,sT2D肠道微生物群中产生短链脂肪酸的分类群、和的相对丰度显著降低,致病共生菌、和增加,以及基因和代谢途径的丰度存在差异。这些结果表明,对T2D个体的肠道微生物群进行表征可以识别“疾病状态”微生物群中的关键因素,这些因素可能会增加神经退行性变的风险或加速其发病。此外,它们还确定了针对微生物群的预防和治疗AD神经炎症的候选方法。