Gut dysbiosis in autoimmune diseases: Association with mortality

Front Cell Infect Microbiol. 2023 Mar 31:13:1157918. doi: 10.3389/fcimb.2023.1157918. eCollection 2023.

Abstract

To better understand the impact of gut dysbiosis on four autoimmune diseases [Sjögren's syndrome (SS), systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and multiple sclerosis (MS)], this review investigated the altered gut bacteria in each disease and the shared ones among the four diseases. The enriched gut bacteria shared by three of the four autoimmune diseases were Streptococcus, Prevotella, and Eggerthella, which are associated with autoantibody production or activation of Th17 cells in immune-related diseases. On the other hand, Faecalibacterium comprises depleted gut bacteria shared by patients with SLE, MS, and SS, which is associated with various anti-inflammatory activities. The indexes of gut dysbiosis, defined as the number of altered gut bacterial taxa divided by the number of studies in SLE, MS, RA, and SS, were 1.7, 1.8, 0.7, and 1.3, respectively. Interestingly, these values presented a positive correlation trend with the standardized mortality rates -2.66, 2.89, 1.54, and 1.41, respectively. In addition, shared altered gut bacteria among the autoimmune diseases may correlate with the prevalence of polyautoimmunity in patients with SLE, SS, RA, and MS, that is, 41 percent, 32.6 percent, 14 percent, and 1-16.6 percent, respectively. Overall, this review suggests that gut dysbiosis in autoimmune diseases may be closely related to the failure of the gut immune system to maintain homeostasis.

Keywords: Sjögren’s syndrome; autoimmunity; gut dysbiosis; multiple sclerosis; rheumatoid arthritis; systemic lupus erythematosus.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Arthritis, Rheumatoid* / complications
  • Autoimmune Diseases* / complications
  • Dysbiosis / complications
  • Humans
  • Lupus Erythematosus, Systemic* / complications
  • Lupus Erythematosus, Systemic* / epidemiology
  • Multiple Sclerosis*
  • Sjogren's Syndrome* / complications
  • Sjogren's Syndrome* / epidemiology

Grants and funding

This study was supported by the National Research Foundation of Korea (Daejun, Korea) through grants 2018R1A5A2024418 and 2020R1A2C2007038 awarded to YC and grant 2020R1A2C1100163 awarded to S-HC.