Abstract：
OBJECTIVE: Pemphigus vulgaris (PV) and bullous pemphigoid (BP) are two prevalent bullous diseases. Previous studies found that the antibodies of BP could be expressed in the intestinal epithelium and BP was tightly related to inflammatory bowel disease. Therefore, gut microbiota might also play an important role in bullous disease. However, the specific relationship between gut microbiota and bullous diseases remains unknown. Our study aimed to investigate the potential role of gut microbiota in the development and progression of different bullous diseases.
METHODS: We conducted a prospective and observational cohort study at Peking Union Medical College Hospital. Untreated BP and PV patients were recruited, along with healthy controls (HC) who were spouses or caregivers of these patients. Fecal samples were collected, followed by 16S rRNA gene sequencing. Bioinformatics analyses were performed to assess the composition and function of gut microbiota.
RESULTS: A total of 38 HC, 32 BP, and 19 PV patients were enrolled in this study. Compared to HC, BP, and PV exhibited a distinct gut microbiota composition, especially BP. The gut microbiota changes were mainly observed in the phylum Bacteroidetes, Firmicutes, and Proteobacteria. The ratio of Faecalibacterium to Escherichia-Shigella (F/E ratio) had a considerable predictive value (AUC: 0.705) for recognizing BP from PV. The levels of Faecalibacterium and Enterobacter were correlated to the anti-BP 180 and anti-desmoglein 3. Microbial functional prediction revealed elevated activity in pathways related to gut microbiota translocation significantly increased in BP patients, indicating a potential pathogenetic role in BP.
CONCLUSIONS: Our study suggests that the composition of gut microbiota is specific in different bullous diseases and the role of gut microbiota differs. Gut microbiota could help distinguish BP and PV, and might play a role in the pathogenesis of different bullous diseases.
METHODS: We conducted a prospective and observational cohort study at Peking Union Medical College Hospital. Untreated BP and PV patients were recruited, along with healthy controls (HC) who were spouses or caregivers of these patients. Fecal samples were collected, followed by 16S rRNA gene sequencing. Bioinformatics analyses were performed to assess the composition and function of gut microbiota.
RESULTS: A total of 38 HC, 32 BP, and 19 PV patients were enrolled in this study. Compared to HC, BP, and PV exhibited a distinct gut microbiota composition, especially BP. The gut microbiota changes were mainly observed in the phylum Bacteroidetes, Firmicutes, and Proteobacteria. The ratio of Faecalibacterium to Escherichia-Shigella (F/E ratio) had a considerable predictive value (AUC: 0.705) for recognizing BP from PV. The levels of Faecalibacterium and Enterobacter were correlated to the anti-BP 180 and anti-desmoglein 3. Microbial functional prediction revealed elevated activity in pathways related to gut microbiota translocation significantly increased in BP patients, indicating a potential pathogenetic role in BP.
CONCLUSIONS: Our study suggests that the composition of gut microbiota is specific in different bullous diseases and the role of gut microbiota differs. Gut microbiota could help distinguish BP and PV, and might play a role in the pathogenesis of different bullous diseases.
摘要：
目的：寻常型天疱疮（PV）和大疱性类天疱疮（BP）是两种常见的大疱性疾病。先前的研究发现，BP的抗体可以在肠上皮中表达，并且BP与炎症性肠病密切相关。因此,肠道菌群也可能在大疱性疾病中发挥重要作用。然而,肠道菌群与大疱性疾病之间的具体关系尚不清楚。我们的研究旨在探讨肠道菌群在不同大疱性疾病发生发展中的潜在作用。
方法：我们在北京协和医院进行了一项前瞻性观察性队列研究。招募未治疗的BP和PV患者，以及作为这些患者的配偶或照顾者的健康对照（HC）。收集粪便样本，然后进行16SrRNA基因测序。进行生物信息学分析以评估肠道微生物群的组成和功能。
结果：共38HC，32BP,19例PV患者纳入本研究。与HC相比，BP,和PV表现出不同的肠道微生物群组成，尤其是BP。肠道菌群变化主要在拟杆菌门，Firmicutes,和变形杆菌。粪杆菌与埃希氏菌-志贺氏菌的比率(F/E比率)对于从PV识别BP具有相当大的预测值(AUC:0.705)。粪杆菌和肠杆菌的水平与抗BP180和抗桥粒蛋白3相关。微生物功能预测显示，BP患者肠道菌群易位相关途径的活性升高，表明在BP中潜在的致病作用。
结论：我们的研究表明，肠道微生物群的组成在不同的大疱性疾病中是特定的，并且肠道微生物群的作用不同。肠道菌群可以帮助区分BP和PV，并可能在不同大疱性疾病的发病机制中起作用。
方法：我们在北京协和医院进行了一项前瞻性观察性队列研究。招募未治疗的BP和PV患者，以及作为这些患者的配偶或照顾者的健康对照（HC）。收集粪便样本，然后进行16SrRNA基因测序。进行生物信息学分析以评估肠道微生物群的组成和功能。
结果：共38HC，32BP,19例PV患者纳入本研究。与HC相比，BP,和PV表现出不同的肠道微生物群组成，尤其是BP。肠道菌群变化主要在拟杆菌门，Firmicutes,和变形杆菌。粪杆菌与埃希氏菌-志贺氏菌的比率(F/E比率)对于从PV识别BP具有相当大的预测值(AUC:0.705)。粪杆菌和肠杆菌的水平与抗BP180和抗桥粒蛋白3相关。微生物功能预测显示，BP患者肠道菌群易位相关途径的活性升高，表明在BP中潜在的致病作用。
结论：我们的研究表明，肠道微生物群的组成在不同的大疱性疾病中是特定的，并且肠道微生物群的作用不同。肠道菌群可以帮助区分BP和PV，并可能在不同大疱性疾病的发病机制中起作用。
