Abstract

This study investigated the association between intestinal microbiota abundance and diversity and cluster of differentiation (CD)4+ T cell subpopulations, cytokine levels, and disease activity in rheumatoid arthritis RA. A total of 108 rheumatoid arthritis (RA) patients and 99 healthy control (HC) subjects were recruited. PICRUSt2 was used for functional metagenomic predictions. Absolute counts of peripheral CD4+ T cell subpopulations and cytokine levels were detected by flow cytometry and with a cytokine bead array, respectively. Correlations were analyzed with the Spearman rank correlation test. The results showed that the diversity of intestinal microbiota was decreased in RA patients compared to HCs. At the phylum level, the abundance of Firmicutes, Fusobacteriota, and Bacteroidota was decreased while that of Actinobacteria and Proteobacteria was increased and at the genus level, the abundance of Faecalibacterium, Blautia, and Escherichia-Shigella was increased while that of Bacteroides and Coprococcus was decreased in RA patients compared to HC subjects. The linear discriminant analysis effect size indicated that Bifidobacterium was the most significant genus in RA. The most highly enriched Kyoto Encyclopedia of Genes and Genomes pathway in RA patients was amino acid metabolism. The relative abundance of Megamonas, Monoglobus, and Prevotella was positively correlated with CD4+ T cell counts and cytokine levels; and the relative numbers of regulatory T cells (Tregs) and T helper (Th17)/Treg ratio were negatively correlated with disease activity in RA. These results suggest that dysbiosis of certain bacterial lineages and alterations in gut microbiota metabolism lead to changes in the host immune profile that contribute to RA pathogenesis.

Highlights

  • Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by irreversible peripheral joint damage (England et al, 2018)

  • Decreased (P < 0.05) whereas that of Actinobacteria and Proteobacteria was increased (P < 0.05) in RA patients compared to healthy control (HC) (Figures 4B,C)

  • The abundance of phylum Actinobacteria, including the genus Bifidobacterium, was increased in RA patients compared to HCs

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Summary

Introduction

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by irreversible peripheral joint damage (England et al, 2018). The etiopathogenic mechanism of RA involves abnormal immune activation with various autoantibodies, an imbalance of lymphocyte subpopulations, and cytokine dysregulation. Alterations in the gut microbiome profile are associated with immune dysfunction in several rheumatic diseases (Li and Wang, 2021). The abundance of intestinal microbiota is known to differ between RA patients and healthy subjects (Vaahtovuo et al, 2008; Scher et al, 2013; Taneja, 2014). Gut dysbiosis may negatively affect immune function in RA (Li and Wang, 2021). Interaction between gut microbiota and the host is important for maintaining immune homeostasis (Chu and Mazmanian, 2013). Gut bacteria have been shown to influence the polarization of lymphocyte subpopulations and their cytokines and thereby regulate immune functions (Abdulla et al, 2021)

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