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格雷夫斯病患者血清细胞因子与肠道微生物群的相关性:一项病例对照研究。

Correlations between serum cytokines and gut microbiota in patients with Graves' disease: A case-control study.

作者信息

Chao Hong, Shan Jie, Che Li Qun, Cheng Yu, Li Hong Jie, Qian Xue Yan

机构信息

School of Public Health, Qiqihar Medical University, Qiqihar, China.

The Third Affiliated Hospital of Qiqihar Medical University, Qiqihar, China.

出版信息

Medicine (Baltimore). 2025 Jun 20;104(25):e43000. doi: 10.1097/MD.0000000000043000.

Abstract

Graves' disease (GD) is the most prevalent autoimmune thyroid disorder. Gut microbiome as a critical modulator of autoimmune pathogenesis through its bidirectional communication with host immunity. To elucidate the pathophysiological interplay between cellular immunity and gut microbiome composition in GD through systematic analysis of associations between peripheral blood cytokine profiles and microbial community dynamics. This case-control study enrolled 30 untreated GD patients consecutively admitted to the Department of Endocrinology at the Third Affiliated Hospital of Qiqihar Medical University between January and July 2023, along with 30 age/sex-matched healthy controls (HC). Comprehensive evaluations included: electrochemiluminescence immunoassay quantification of thyroid function parameters, high-resolution Illumina HiSeq 2000 platform-based 16S rRNA gene sequencing for fecal microbial community profiling, multiplex cytokine array analysis of peripheral blood immune markers. Spearman correlation analyses were conducted to delineate relationships among cytokines, thyroid function index and gut microbial taxa alterations in GD pathogenesis. Alpha diversity analysis revealed that the abundance and diversity of certain microbiota in the GD group decreased. Beta diversity analysis revealed that the intestinal microbiome composition of GD patients was significantly different from that of HC. The proportion of Firmicutes in patients with GD was lower than that in HC, while the proportion of Bacteroidetes in patients with GD was greater than that in HC. Immunoregulatory cytokine interleukin-10 exhibited positive correlations with commensal genera Bifidobacterium (R = 0.28) and Parasutterella (R = 0.30), while showing negative correlations with the pathobionts Prevotella_9 (r = -0.51) and Megamonas (r = -0.31). Transforming growth factor β demonstrated similar positive correlations with Bifidobacterium (R = 0.31) and negative correlations with Prevotella_9 (r = -0.45) and Megamonas (r = -0.38). Interleukin-17A displayed positive correlated with Prevotella_9 (R = 0.43) and Megamonas (R = 0.32), but negative correlations with Bifidobacterium (r = -0.27), Veillonella (r = -0.47), Prevotella_9 (r = -0.51) and Megamonas (r = -0.31). Clinically, key microbial taxa showed significant associations with thyroid dysfunction parameters. Our findings identify that GD gut ecosystem demonstrates profound microbial dysbiosis characterized by depleted commensal symbionts and expansion of immunomodulatory pathobionts. Specific bacterial taxa correlate with both cytokine and clinical thyroid dysfunction markers.

摘要

格雷夫斯病(GD)是最常见的自身免疫性甲状腺疾病。肠道微生物群通过与宿主免疫系统的双向交流,成为自身免疫发病机制的关键调节因子。通过系统分析外周血细胞因子谱与微生物群落动态之间的关联,以阐明GD中细胞免疫与肠道微生物群组成之间的病理生理相互作用。本病例对照研究连续纳入了2023年1月至7月齐齐哈尔医学院附属第三医院内分泌科收治的30例未经治疗的GD患者,以及30例年龄/性别匹配的健康对照(HC)。综合评估包括:采用电化学发光免疫分析法对甲状腺功能参数进行定量,基于高分辨率Illumina HiSeq 2000平台的16S rRNA基因测序对粪便微生物群落进行分析,采用多重细胞因子阵列分析法对外周血免疫标志物进行分析。进行Spearman相关性分析以描绘细胞因子、甲状腺功能指标和GD发病机制中肠道微生物分类群改变之间的关系。α多样性分析显示,GD组中某些微生物群的丰度和多样性降低。β多样性分析显示,GD患者的肠道微生物群组成与HC有显著差异。GD患者中厚壁菌门的比例低于HC,而拟杆菌门的比例高于HC。免疫调节细胞因子白细胞介素-10与共生菌属双歧杆菌(R = 0.28)和副萨特氏菌(R = 0.30)呈正相关,而与致病共生菌普氏菌属9(r = -0.51)和巨单胞菌(r = -0.31)呈负相关。转化生长因子β与双歧杆菌也表现出类似的正相关(R = 0.31),与普氏菌属9(r = -0.45)和巨单胞菌(r = -0.38)呈负相关。白细胞介素-17A与普氏菌属9(R = 0.43)和巨单胞菌(R = 0.32)呈正相关,但与双歧杆菌(r = -0.27)、韦荣球菌(r = -0.47)、普氏菌属9(r = -0.51)和巨单胞菌(r = -0.31)呈负相关。临床上,关键的微生物分类群与甲状腺功能障碍参数有显著关联。我们的研究结果表明,GD肠道生态系统表现出严重的微生物失调,其特征是共生共生菌减少和免疫调节致病共生菌扩张。特定的细菌分类群与细胞因子和临床甲状腺功能障碍标志物均相关。

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