Abstract
Increasing evidence suggested that gut microbiota played critical roles in developing autoimmune diseases. This study investigated the correlation between gut microbiota and antineutrophil cytoplasmic antibody-associated vasculitis (AAV) with kidney injury. We analyzed the fecal samples of 23 AAV patients with kidney injury using a 16s RNA microbial profiling approach. The alpha-diversity indexes were significantly lower in AAV patients with kidney injury than healthy controls (Sobs P < 0.001, Shannon P < 0.001, Chao P < 0.001). The beta-diversity difference demonstrated a significant difference among AAV patients with kidney injury, patients with lupus nephritis (LN), and health controls (ANOSIM, p = 0.001). Among these AAV patients, the Deltaproteobacteria, unclassified_o_Bacteroidales, Prevotellaceae, Desulfovibrionaceae Paraprevotella, and Lachnospiraceae_NK4A136_group were correlated negatively with serum creatinine, and the proportion of Deltaproteobacteria, unclassified_o_Bacteroidales, Desulfovibrionaceae, Paraprevotella, and Lachnospiraceae_NK4A136_group had a positive correlation with eGFR. In conclusion, the richness and diversity of gut microbiota were reduced in AAV patients with kidney injury, and the alteration of gut microbiota might be related with the severity of kidney injury of AAV patients. Targeted regulation of gut microbiota disorder might be a potential treatment for AAV patients with kidney injury.
Highlights
Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a group of systemic diseases characterized by pauci-immune necrotizing inflammation of the small blood vessels, which includes microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA), and eosinophilic granulomatosis with polyangiitis (EGPA)
There were no significant differences in the above indexes between AAV patients with kidney injury and patients with lupus nephritis (LN)
The beta-diversity difference using the Bray Curtis was exhibited in principal coordinates analysis (PCoA) analysis (Figure 1C), which demonstrated a clear difference among AAV patients with kidney injury, patients with LN, and health controls (ANOSIM, p = 0.001)
Summary
Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a group of systemic diseases characterized by pauci-immune necrotizing inflammation of the small blood vessels, which includes microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA), and eosinophilic granulomatosis with polyangiitis (EGPA). ANCAs, mainly targeting at myeloperoxidase (MPO) and proteinase 3 (PR3), were usually the serological markers of AAV. AAV involves multiple organs, predominantly the lungs and the kidneys (Nakazawa et al, 2019). The overall annual incidence of AAV was about 20 per million with a poor survival rate and high recurrence rate Gut Microbiota in AAV and Robson, 2018). Most patients with AAV suffered from chronic morbidity, including about 35.5% of patients with dialysis-dependent (Hoffman et al, 1992; Flossmann et al, 2011; Binda et al, 2018). The pathogenesis of AAV remained not clear, AAV was currently considered to be caused by multifactorial factors, including genetics, environmental factors, and responses of the innate and adaptive immune systems (Geetha and Jefferson, 2020)
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