Shared Gut Dysbiosis in Crohn’s Disease, Spondyloarthritis, & Acute Anterior Uveitis

Researchers found a low abundance of Fusicatenibacter, Anaerostipes, and Blautia among patients with Crohn’s disease (CD), spondyloarthritis (SpA), and acute anterior uveitis (AAU), a recent population-based cohort study published in Arthritis Rheumatology revealed.

“We analyzed a large human cohort comprising all 3 diseases and deeply explored the taxonomic composition of the gut microbiota with clinical covariates and disease concomitance for the first time,” the authors wrote. The findings indicate that “CD, AAU, and SpA share an established epidemiology, yet the pathophysiology underlying their concomitance remains unclear.”

For the cross-sectional analysis, the team recruited 277 patients from the German Spondyloarthritis Inception Cohort. Of these, 102 patients had SpA, 72 had CD, and 103 had AAU.

All participants were treatment naïve or had not received treatment with biological disease-modifying antirheumatic drugs (bDMARDs) for 3 months or longer prior to study enrollment. They had also not received systemic antibiotic therapy for at least 1 month prior to the baseline stool sample. The control group included adults who had chronic back pain but did not have SpA, CD, AAU, or psoriasis.

Around 20% of the patients with CD, and more than 50% of the patients with AAU, presented with predominantly axial SpA. Also, 5 cases of CD and 3 cases of AAU were diagnosed with exclusively peripheral SpA.

Further analyses revealed a low abundance of Fusicatenibacter, Anaerostipes, and Blautia across the disease groups.

Patients with significantly higher abundances of Flavonifractor were related to the CD phenotypes, and those with higher abundances of Collinsella were related to the SpA phenotypes. No significant associations were reported for the AAU phenotype.

“Taken together, our results suggest there is much more to be uncovered about the immunomodulatory properties of certain bacteria in these epidemiologically-related pathologies, especially at the molecular level, in order to eventually leverage the diagnostic and therapeutic potential of the microbiome,” the authors concluded.

Reference:
Essex, M, Rios R, Rademacher J et al. Shared and distinct gut microbiota in spondyloarthritis, acute anterior uveitis, and Crohn's disease. Arthritis Rheumatol. 2024; 76:48-58. DOI: https://doi.org/10.1002/art.42658