AB0001 GUT MICROBIOTA IMBALANCE IN INFLAMMATORY ARTHRITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

BackgroundInflammatory arthritis (IA) is a group of autoimmune arthritis characterized by a pro-inflammatory/anti-inflammatory disbalance of local mediators[1][2]. Research on the influence of gut microbiota(GM) on systemic IA has exploded in the past decade. GM changes may be a crucial regulatory component in systemic IA[3]. However, the link between them has yet to be fully elucidated.ObjectivesThis study aims to study the GM composition of IA to provide evidence for its potential role in the pathogenesis, progress, and treatment of IA.MethodsWe systematically searched the trials for PubMed, EMBASE, Web of Science, Medline, Wanfang database, VIP, CNKI, and CBM database from the establishment of the database to January 1, 2023. Standardized mean difference (SMD) and 95% confidence interval (CI) were calculated to assess alterations in α-diversity and the abundance of certain microbiota families in IA. Literature quality was evaluated according to the requirements of systematic review, and meta-analysis was performed using STATA v.12.0.ResultsA total of 70 studies, including 3,322 patients and 4,412 healthy controls, were identified. Compared with HCs, the GM of patients with IA has a lower Simpson index(SMD=-0.307, 95%CI -0.509, -0.106) and Shannon index(SMD=-0.184, 95%CI -0.344, -0.024). When specific IA was examined, significant decreases were observed in rheumatoid arthritis(Simpson index: SMD=-0.558, 95%CI -0.891, -0.225; Shannon index: SMD=-0.608, 95%CI -0.935, -0.281; ACE: SMD=-0.414, 95%CI -0.697, -0.132; Chao1: SMD= -1.373, 95%CI -1.980, -0.766; eveness index: SMD=-1.863, 95%CI -3.181, -0.544), psoriatic arthritis(Simpson index: SMD=-0.733, 95%CI -1.367, -0.099), osteoarthritis(Chao1: SMD=-0.793, 95%CI -1.096, -0.491) and gout(Simpson index: SMD=-1.037, 95%CI -1.959, -0.115). In other diseases, we found that the α-diversity index was higher than that of the HCs group[reactive arthritis(Shannon index: SMD=0.697, 95%CI 0.265, 1.130; ACE: SMD=1.878, 95%CI 1.375, 2.380; Chao1:SMD=0.835, 95%CI 0.398, 1.273; InvSimpson: SMD=0.823, 95%CI 0.386, 1.260; Observed species: SMD= 2.004, 95%CI 1.491, 2.517); osteoporosis(eveness index: SMD=0.488, 95%CI 0.047, 0.928); ankylosing spondylitis(InvSimpson: SMD=0.525, 95%CI 0.272, 0.777); Juvenile idiopathic arthritis(Observed species: SMD=1.672, 95%CI 1.100, 2.243)]. Furthermore, to exclude sequencing methods’ influence on species abundance detection, we conducted a subgroup analysis of Observed species. The results showed that the observed species abundance through high-throughput sequencing was higher(SMD=1.376, 95%CI 0.394, 2.358) and 16S rRNA gene sequencing was lower(SMD=-0.842, 95%CI -1.575, -0.108) than that of HC. At the phylum level, there was a significant reduction inFirmicutes(SMD=-0.455, 95%CI -0.796, -0.114) andFusobacteria(SMD=-0.422, 95%CI -0.692, -0.152). At the genus level, the abundance ofBacteroides(SMD=0.898, 95%CI 0.003, 0.003) was higher andFaecalibacterium(SMD=-0.380, 95%CI -0.713, -0.047) was lower. The two groups had no significant differences inBifidobacteriumandButyricicoccus(P >0.05).ConclusionOur research showed a definite relationship between IA and GM. Further diet and drug therapy research are needed to explore the relationship between human GM and IA.