Pryor Jennifer C, Nieva Cheenie, Talley Nicholas J, Eslick Guy D, Duncanson Kerith, Burns Grace L, Hoedt Emily C, Keely Simon
College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia.
National Health and Medical Research Council (NHMRC), Centre of Research Excellence in Digestive Health, The University of Newcastle, Newcastle, NSW, Australia.
Gut Microbes. 2025 Dec;17(1):2500063. doi: 10.1080/19490976.2025.2500063. Epub 2025 May 9.
Dietary gluten triggers symptoms in patients with gluten-related disorders (GRDs) including celiac disease (CeD), non-celiac gluten sensitivity (NCGS), and subsets of patients with functional dyspepsia (FD). The gastrointestinal microbiota is altered in these patients when compared to healthy individuals. As the microbiota is crucial for the hydrolysis of gluten, we hypothesized that the capacity of the microbiota to digest gluten is reduced in these conditions. We systematically reviewed and re-analyzed published datasets to compare gastrointestinal microbiomes of GRD patients and identify signals explaining gluten responses. A systematic search of five databases was conducted to identify studies where the microbiota of CeD, NCGS, or FD patients was analyzed by 16S rRNA amplicon or shotgun metagenomic sequencing and compared to control populations. Where available, raw duodenal microbiota sequence data were re-analyzed with a consistent bioinformatic pipeline. Thirty articles met the inclusion criteria for this systematic review. Microbiota diversity metrics were not impacted by the diseases; however, genera including , , and were commonly altered in GRD patients. Re-analysis of duodenal 16S rRNA data was possible for five included articles but did not identify any consistent differentially abundant taxa. Predicted functional analysis of the microbiome revealed that peptidases including aminopeptidase, proline iminopeptidase, and Xaa-Pro dipeptidase are altered in CeD, NCGS, and FD, respectively. These microbial-derived peptidases hydrolyze bonds in proline-rich gluten peptides. While the gastrointestinal microbiota in patients with GRDs differ from controls, no distinct phenotype links them. However, alterations to the predicted functional capacity of the microbiome to produce gluten-hydrolyzing enzymes suggest that inappropriate digestion of gluten by the microbiome impacts host responses to dietary gluten in these conditions. These findings have implications for therapeutic management of GRDs, as treatment with gluten-degrading enzymes or tailored probiotics could improve disease outcomes by enhancing gluten digestion into non-reactive peptides.
膳食中的麸质会引发麸质相关疾病(GRD)患者出现症状,这些疾病包括乳糜泻(CeD)、非乳糜泻麸质敏感(NCGS)以及功能性消化不良(FD)患者亚组。与健康个体相比,这些患者的胃肠道微生物群发生了改变。由于微生物群对于麸质的水解至关重要,我们推测在这些情况下,微生物群消化麸质的能力会降低。我们系统地回顾并重新分析了已发表的数据集,以比较GRD患者的胃肠道微生物群,并确定解释麸质反应的信号。我们对五个数据库进行了系统搜索,以确定通过16S rRNA扩增子或鸟枪法宏基因组测序分析CeD、NCGS或FD患者的微生物群并与对照人群进行比较的研究。在可行的情况下,使用一致的生物信息学流程对原始十二指肠微生物群序列数据进行了重新分析。三十篇文章符合本系统评价的纳入标准。疾病并未影响微生物群多样性指标;然而,包括[未提及具体属名]、[未提及具体属名]和[未提及具体属名]在内的属在GRD患者中通常发生改变。对五篇纳入文章的十二指肠16S rRNA数据进行重新分析是可行的,但未发现任何一致的差异丰富分类群。微生物群的预测功能分析表明,包括氨肽酶、脯氨酸亚氨基肽酶和Xaa-Pro二肽酶在内的肽酶在CeD、NCGS和FD中分别发生了改变。这些微生物衍生的肽酶水解富含脯氨酸的麸质肽中的键。虽然GRD患者的胃肠道微生物群与对照组不同,但没有明显的表型将它们联系起来。然而,微生物群产生麸质水解酶的预测功能能力的改变表明,在这些情况下,微生物群对麸质的不适当消化会影响宿主对膳食麸质的反应。这些发现对GRD的治疗管理具有启示意义,因为用麸质降解酶或定制益生菌进行治疗可能通过增强麸质消化为无反应性肽来改善疾病结局。
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