Normal gut microbiome in NMDA receptor encephalitis
Normal gut microbiome in NMDA receptor encephalitis
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DOI：
10.1212/nxi.0000000000000632
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发表时间：
2019-11-01
影响因子：
8.8
通讯作者：
Pruess, Harald
中科院分区：
文献类型：
--
作者：
Herken, Julia;Bang, Corinna;Pruess, Harald
目的确定抗NMDA受体（NMDAR）脑炎患者的肠道微生物群是否显示出与MS或视神经肌萎缩症患者相似的肠道细菌种类过多，在MS或视神经肌萎缩症患者中，它们可能平衡促炎和抗炎免疫应答或通过分子模拟参与疾病发病机制。（n = 23，平均年龄：34 +/-12.7岁; 21名女性）和年龄/性别/环境匹配的健康对照（n = 24，40 +/-14.2岁; 22名女性），使用粪便细菌16 S rDNA测序和操作分类单位（OTU）分类。统计分析集中在个体内和个体间的细菌多样性和差异丰富的taxa. ResultsNMDAR脑炎和对照组患者有类似的肠道菌群的微生物组配置文件关于个体内的细菌多样性，OTU分布，区域和当地物种多样性之间的比例时，测试所有OTU，属的相对丰度大于0.5%。同样，患有卵巢畸胎瘤的NMDAR脑炎患者亚组（n = 3）与对照组相比，微生物组变化无差异。急性脑炎阶段的患者（n = 8）在梭菌XVIII，梭菌IV，颤杆菌，普雷沃氏菌和布劳特氏菌的数量显着差异;然而，校正后的多重testing.ConclusionPatients NMDAR脑炎和对照组都有正常的肠道微生物组的意义丢失。患者中某些细菌物种的过量缺乏表明微生物组变化不是NMDAR脑炎的发病机制，病程或预后的主要贡献者。尽管样本量小，异质性组，研究结果表明其他神经免疫疾病的差异。
ObjectiveTo determine whether the gut microbiota shows overabundance of commensal bacteria species in patients with anti-NMDA receptor (NMDAR) encephalitis, similar to patients with MS or neuromyelitis optica where they potentially balance pro- and anti-inflammatory immune responses or participate in disease pathogenesis by molecular mimicry.MethodsIntestinal microbiota was characterized in patients with NMDAR encephalitis (n = 23, mean age: 34 +/- 12.7 years; 21 females) and age/sex/environment-matched healthy controls (n = 24, 40 +/- 14.2 years; 22 females) using stool bacteria 16S rDNA sequencing and classification in operational taxonomic units (OTUs). Statistical analyses focused on intraindividual and interindividual bacterial diversity and identification of differentially abundant taxa.ResultsPatients with NMDAR encephalitis and controls had similar microbiome profiles of the gut microbiota regarding intraindividual bacterial diversity, OTU distribution, ratio between regional and local species diversity when testing all OTUs, and genera with a relative abundance greater than 0.5%. Similarly, the subgroup of NMDAR encephalitis patients with an ovarian teratoma (n = 3) showed no differences in microbiome variation compared with controls. Patients in the acute encephalitis stage (n = 8) showed significant differences in the numbers of Clostridium XVIII, Clostridium IV, Oscillibacter, Prevotella, and Blautia; however, significance was lost after correction for multiple testing.ConclusionPatients with NMDAR encephalitis and controls both had a normal gut microbiome. The lack of overabundance of certain bacterial species in patients suggests that microbiome changes are no major contributors to the pathogenesis, disease course, or prognosis in NMDAR encephalitis. Despite the small sample size and heterogeneous groups, findings indicate differences to other neuroimmunologic diseases.