Fecal microbiome differs between patients with systemic sclerosis with and without small intestinal bacterial overgrowth.
JOURNAL OF SCLERODERMA AND RELATED DISORDERS 2021;
6:290-298. [PMID:
35382497 PMCID:
PMC8922657 DOI:
10.1177/23971983211032808]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 06/24/2021] [Indexed: 01/04/2023]
Abstract
Introduction:
Gastrointestinal manifestations of systemic sclerosis affect up to 90% of
patients, with symptoms including diarrhea and constipation. Small
intestinal bacterial overgrowth is a condition associated with increased
numbers of pathogenic bacteria in the small bowel. While currently unknown,
it has been suggested that dysregulation of the fecal microbiota may play a
role in the development of systemic sclerosis and small intestinal bacterial
overgrowth.
Objectives:
Our study aimed to describe the fecal microbiota of patients with systemic
sclerosis and compare it between those with and without a diagnosis of small
intestinal bacterial overgrowth. We also compared the fecal microbiota of
systemic sclerosis patients with that of healthy controls to understand the
association between particular bacterial taxa and clinical gastrointestinal
manifestations of systemic sclerosis.
Methods:
A total of 29 patients with systemic sclerosis underwent breath testing to
assess for small intestinal bacterial overgrowth, provided stool samples to
determine taxonomic assignments, and completed the University of California
Los Angeles Scleroderma Clinical Trial Consortium Gastrointestinal Tract
2.0, which details symptoms and quality-of-life factors. Stool samples were
compared between systemic sclerosis patients with and without small
intestinal bacterial overgrowth, and between patients with systemic
sclerosis and a healthy control cohort (n = 20), aged 18–80 years.
Results:
Fecal microbiome analyses demonstrated differences between systemic sclerosis
patients with and without small intestinal bacterial overgrowth and
differences in the diversity of species between healthy controls and
patients with systemic sclerosis. Trends were also observed in
anticentromere antibody systemic sclerosis patients, including higher
Alistipies indistincus spp. levels associated with
increased methane levels of breath gas testing and higher
Slakia spp. levels associated with increased rates of
fecal soiling.
Conclusions:
Our results suggest that changes to the fecal microbiome occur in patients
with small intestinal bacterial overgrowth and systemic sclerosis when
compared to healthy controls. As a cross-sectional study, the potential
pathophysiologic role of an altered microbiome in the development of
systemic sclerosis was not considered and hence needs to be further
investigated.
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