Altered gut microbiota and their metabolites in patients with myasthenia gravis
Journal Title: Chinese Journal of Nervous and Mental Diseases - Year 2024, Vol 50, Issue 6
Abstract
ObjectiveThis study investigated whether gut microbiota and its metabolites are altered in myasthenia gravis (MG) patients.MethodsWe collected fresh stool specimens from MG patients and healthy controls. 16S rRNA gene sequencing and gas chromatography-mass spectrometry were used to measure abundance of gut microbiota and metabolite levels in two groups, respectively. Clinical data of the subjects were also collected including quantitative MG score (QMGS), MG-activities of daily living (MG-ADL), MG-specific quality-of-life 15 (MG-QOL15), manual muscle testing (MMT), and the acetylcholine receptor antibody (AchR-Ab) titers. The correlation between the differential microbiota and the clinical characteristics was investigated.ResultsA total of 50 MG patients and 15 healthy controls were recruited. Simpsonâs index was significantly higher in the MG group (0.936±0.041) than in the control group (0.888±0.123). Alpha diversity was significantly decreased in the MG group (t=2.349, P=0.022). There was a significant difference in microbial phenotype between the two groups (R=0.966, P=0.001, Adonis). The results of LEfSe showed that the abundance of Esherichia-Shigella, Succinivibrio, Fusobacterium, and Ruminococcus-gnavus-group were up-regulated while the abundance of Lachnospira, Roseburia, Desulfovibrio, and Coprococcus were down-regulated. The results showed that the metabolites of the MG group were significantly different from those of the control group. There were 28 metabolites up-regulated and 71 metabolites down-regulated in the MG patient group. Kyoto Encyclopedia of Genes and Genomes analyses demonstrated that the majority of metabolic pathways in which differential metabolites were involved were related to amino acid metabolism and nucleotide metabolism. 61.2% (30/49) of bacterial amplicon sequence variant (ASV) were significantly associated with multiple metabolites (P<0.001). The relative abundance of Lachnospiraceae in the group with MG was negatively correlated with the QMGS (r=-0.496, P<0.001), MG-ADL (r=-0.542, P<0.001), MG-QOL15 (r=-0.464, P=0.007), and the AchR-Ab (r=-0.315, P=0.026). The relative abundance of Lachnospiraceae in the group with MG was positively correlated with the MMT (r=0.374, P=0.008).ConclusionThe intestinal flora of MG patients is down-regulated in the abundance of beneficial bacteria and up-regulated in the abundances of harmful bacteria. Disturbance of metabolites are also present in MG patients. Regulating gut microbiota in MG patients may be a new target for treating the disease.
Authors and Affiliations
WU Qian,LI Junlian,LI Haiyan,HU Wanzhen,ZHANG Xiaoyan,
Keywords
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