Wen Xiaoting, Ogunrinde Elizabeth, Wan Zhuang, Cunningham Melissa, Gilkeson Gary, Jiang Wei
Medical University of South Carolina, Charleston.
Morton Plant North Bay Hospital, BayCare Health System, Lutz, Florida.
ACR Open Rheumatol. 2024 Jun;6(6):365-374. doi: 10.1002/acr2.11664. Epub 2024 Apr 2.
Black groups have increased prevalence and accelerated pathogenicity of systemic lupus erythematosus (SLE) compared to other ethnic/racial groups. The microbiome and systemic microbial translocation are considered contributing factors to SLE disease pathogenesis. However, racial differences in the plasma microbiome and microbial translocation in lupus remain unknown.
In the current study, we investigated plasma levels of microbial translocation (lipopolysaccharide [LPS] and zonulin) and the plasma microbiome using microbial 16S RNA sequencing of Black and White patients with SLE and Black and White healthy controls.
Plasma microbial translocation was increased in Black patients versus in White patients and in patients with SLE versus healthy controls regardless of race. Compared to sex, age, and disease status, race had the strongest association with plasma microbiome differences. Black groups (Black controls and Black patients) had lower α-diversity than White groups (White controls and White patients) and more distinct β-diversity. Black and White patients demonstrated differences in plasma bacterial presence, including Staphylococcus and Burkholderia. Compared to White patients, Black patients had higher SLE Disease Activity Index (SLEDAI) scores and urinary protein levels as well as a trend for increased anti-double-stranded DNA (dsDNA) antibody levels consistent with the known increased severity of lupus in Black patients overall. Certain plasma bacteria at the genus level were identified that were associated with the SLEDAI score, urinary protein, and anti-dsDNA antibody levels.
This study reveals racial differences in both quality and quantity of plasma microbial translocation and identified specific plasma microbiome differences associated with SLE disease pathogenesis. Thus, this study may provide new insights into future potential microbiome therapies on SLE pathogenesis.
与其他种族群体相比，黑人系统性红斑狼疮（SLE）的患病率更高且致病性更强。微生物群和全身微生物易位被认为是SLE发病机制的促成因素。然而，狼疮患者血浆微生物群和微生物易位的种族差异尚不清楚。
在本研究中，我们通过对患有SLE的黑人和白人患者以及黑人和白人健康对照进行微生物16S RNA测序，研究了微生物易位（脂多糖[LPS]和zonulin）的血浆水平以及血浆微生物群。
无论种族如何，黑人患者的血浆微生物易位均高于白人患者，SLE患者高于健康对照。与性别、年龄和疾病状态相比，种族与血浆微生物群差异的关联最强。黑人组（黑人对照和黑人患者）的α多样性低于白人组（白人对照和白人患者），β多样性更明显。黑人和白人患者在血浆细菌存在方面存在差异，包括葡萄球菌和伯克霍尔德菌。与白人患者相比，黑人患者的SLE疾病活动指数（SLEDAI）评分、尿蛋白水平更高，抗双链DNA（dsDNA）抗体水平有升高趋势，这与已知黑人患者狼疮总体严重程度增加一致。在属水平上鉴定出某些与SLEDAI评分、尿蛋白和抗dsDNA抗体水平相关的血浆细菌。
本研究揭示了血浆微生物易位在质量和数量上的种族差异，并确定了与SLE发病机制相关的特定血浆微生物群差异。因此，本研究可能为未来针对SLE发病机制的潜在微生物群疗法提供新的见解。
