Cui YangLin, Guo YuMeng, Kong YuChen, Zhang GuangYe
First Clinical College of Medicine, Shandong University of Chinese Medicine, Jinan, China.
Classical Chinese Medicine Section, Rizhao Hospital of Traditional Chinese Medicine, Rizhao, China.
Front Microbiol. 2024 Mar 27;15:1348027. doi: 10.3389/fmicb.2024.1348027. eCollection 2024.
BACKGROUND: Previous studies have suggested that the gut microbiota (GM) is closely associated with the development of autoimmune cholestatic liver disease (ACLD), but limitations, such as the presence of confounding factors, have resulted in a causal relationship between the gut microbiota and autoimmune cholestatic liver disease that remains uncertain. Thus, we used two-sample Mendelian randomization as a research method to explore the causal relationship between the two. METHODS: Pooled statistics of gut microbiota from a meta-analysis of genome-wide association studies conducted by the MiBioGen consortium were used as an instrumental variable for exposure factors. The Pooled statistics for primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC) were obtained from the R9 version of the FinnGen database (https://r9.finngen.fi/). Inverse-variance Weighted (IVW), cML-MA, MR-Egger regression, Weighted median (WME), Weighted mode (WM), and Simple mode (SM) were used to detect the association between intestinal flora and the causal relationship between intestinal flora and ACLD, in which IVW method was dominant, was assessed based on the effect indicator dominance ratio (odds ratio, OR) and 95% confidence interval (CI). Sensitivity analysis, heterogeneity test, gene pleiotropy test, MR pleiotropy residual sum and outlier test (MR-PRESSO) were combined to verify the stability and reliability of the results. Reverse Mendelian randomization analysis was performed on gut microbiota and found to be causally associated with ACLD. RESULTS: The IVW results showed that the relative abundance of the genus group, genus , and genus was negatively correlated with the risk of PBC, that is, increased abundance reduced the risk of PBC and was a protective, and the relative abundance of the genus was positively correlated with the risk of PSC, which is a risk factor for PSC. Family and family were negatively correlated with the risk of PSC, which is a protective factor for PSC. CONCLUSION: This study found a causal relationship between gut microbiota and ACLD. This may provide valuable insights into gut microbiota-mediated pathogenesis of ACLD. It is necessary to conduct a large-sample randomized controlled trial (RCT) at a later stage to validate the associated role of the relevant gut microbiota in the risk of ACLD development and to explore the associated mechanisms.
背景:先前的研究表明,肠道微生物群(GM)与自身免疫性胆汁淤积性肝病(ACLD)的发生密切相关,但存在混杂因素等局限性,导致肠道微生物群与自身免疫性胆汁淤积性肝病之间的因果关系仍不确定。因此,我们采用两样本孟德尔随机化作为研究方法来探究两者之间的因果关系。 方法:将MiBioGen联盟进行的全基因组关联研究的荟萃分析中肠道微生物群的汇总统计数据用作暴露因素的工具变量。原发性胆汁性胆管炎(PBC)和原发性硬化性胆管炎(PSC)的汇总统计数据来自FinnGen数据库(https://r9.finngen.fi/)的R9版本。采用逆方差加权(IVW)、cML-MA、MR-Egger回归、加权中位数(WME)、加权模式(WM)和简单模式(SM)来检测肠道菌群与ACLD之间的关联以及肠道菌群与ACLD之间的因果关系,其中以IVW方法为主,基于效应指标优势比(比值比,OR)和95%置信区间(CI)进行评估。结合敏感性分析、异质性检验、基因多效性检验、MR多效性残差和异常值检验(MR-PRESSO)来验证结果的稳定性和可靠性。对肠道微生物群进行反向孟德尔随机化分析,发现其与ACLD存在因果关联。 结果:IVW结果显示,属组、属和属的相对丰度与PBC风险呈负相关,即丰度增加降低了PBC风险,是一种保护因素,而属的相对丰度与PSC风险呈正相关,是PSC的一个风险因素。科和科与PSC风险呈负相关,是PSC的保护因素。 结论:本研究发现肠道微生物群与ACLD之间存在因果关系。这可能为肠道微生物群介导的ACLD发病机制提供有价值的见解。后期有必要进行大样本随机对照试验(RCT),以验证相关肠道微生物群在ACLD发生风险中的相关作用,并探索相关机制。
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