Abstract
Autoimmune hepatitis (AIH) is a chronic inflammatory disorder with complex immunopathogenesis. Dysbiosis has been linked to many autoimmune diseases, but its detailed role in autoimmune hepatitis (AIH) still needs rigorous evaluation, especially in Egypt. We aimed to identify the shift in the gut microbiota profile and resultant metabolic pathways in AIH Egyptian patients compared to healthy individuals. Stool samples were collected from 15 AIH-naive patients and from 10 healthy individuals. The V3-V4 hyper-variable regions in16S rRNA gene was amplified and sequenced using Illumina MiSeq platform. Significantly lower bacterial diversity in AIH patients was found compared to the controls. A phylum-level analysis showed the overrepresentation of Firmicutes, Bacteroides, and Proteobacteria. At the genus level, AIH-associated enrichment of Faecalibacterium, Blautia, Streptococcus, Haemophilus, Bacteroides, Veillonella, Eubacterium, Lachnospiraceae and Butyricicoccus was reported in contrast to Prevotella, Parabacteroides and Dilaster, which were significantly retracted in such patients. Overall, the predicted metabolic pathways associated with dysbiosis in AIH patients could orchestrate the potential pathogenic roles of gut microbiota in autoimmune disease, though not in a disease-specific manner, calling for future large-scale studies.
Highlights
Autoimmune hepatitis (AIH) is a chronic immune-mediated inflammatory liver disease of uncertain cause [1]
We aimed to identify the shift in the intestinal microbiota profile and the resultant alteration in the metabolic pathways in Egyptian patients with AIH compared to healthy individuals
The gut microbiota of steroid treatment-naive AIH were characterized by lower alpha diversity (Shannon and observed operational taxonomic units, both p < 0.01) and a distinct overall microbial composition compared with healthy controls (p = 0.002) [21]
Summary
Autoimmune hepatitis (AIH) is a chronic immune-mediated inflammatory liver disease of uncertain cause [1]. It is characterized histologically by interface hepatitis and the presence of plasma cells, biochemically by the presence of elevated serum transaminase levels, and serologically by increased levels of immunoglobulin G (IgG) with the presence of elevated autoantibodies [2]. AIH can affect any age groups, with type 1 AIH being more common in adults. It is more common in females with a ratio of 3.5 to one and in association with other autoimmune diseases [3]. Progressive hepatic fibrosis occurs in 25% of patients [4]
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