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Published on: January 9, 2018
Normal gut microbiome in NMDA receptor encephalitis
Julia Herken1, Corinna Bang1, Malte C Rühlemann1
1From the German Center for Neurodegenerative Diseases (DZNE) (J.H., H.P.); Department of Neurology and Experimental Neurology (J.H., C.F., J.K., H.P.), Charité - Universitätsmedizin, Berlin; and Institute of Clinical Molecular Biology (C.B., M.C.R., A.F.), Christian Albrechts University of Kiel, Germany.
Objective:
To determine whether the gut microbiota shows overabundance of commensal bacteria species in patients with anti-NMDA receptor (NMDAR) encephalitis, similar to patients with MS or neuromyelitis optica where they potentially balance pro- and anti-inflammatory immune responses or participate in disease pathogenesis by molecular mimicry.
Methods:
Intestinal microbiota was characterized in patients with NMDAR encephalitis (n = 23, mean age: 34 ± 12.7 years; 21 females) and age/sex/environment-matched healthy controls (n = 24, 40 ± 14.2 years; 22 females) using stool bacteria 16S rDNA sequencing and classification in operational taxonomic units (OTUs). Statistical analyses focused on intraindividual and interindividual bacterial diversity and identification of differentially abundant taxa.
Results:
Patients with NMDAR encephalitis and controls had similar microbiome profiles of the gut microbiota regarding intraindividual bacterial diversity, OTU distribution, ratio between regional and local species diversity when testing all OTUs, and genera with a relative abundance greater than 0.5%. Similarly, the subgroup of NMDAR encephalitis patients with an ovarian teratoma (n = 3) showed no differences in microbiome variation compared with controls. Patients in the acute encephalitis stage (n = 8) showed significant differences in the numbers of Clostridium XVIII, Clostridium IV, Oscillibacter, Prevotella, and Blautia; however, significance was lost after correction for multiple testing.
Conclusion:
Patients with NMDAR encephalitis and controls both had a normal gut microbiome. The lack of overabundance of certain bacterial species in patients suggests that microbiome changes are no major contributors to the pathogenesis, disease course, or prognosis in NMDAR encephalitis. Despite the small sample size and heterogeneous groups, findings indicate differences to other neuroimmunologic diseases.
Insights
The gut microbiome in anti-NMDA receptor (NMDAR) encephalitis patients appears normal, suggesting gut bacteria are not a major factor in disease development or progression. This contrasts with other neuroimmune conditions.
Area of Science:
- Neuroimmunology
- Microbiome Research
- Gastroenterology
Background:
- Gut microbiota dysbiosis is implicated in various neuroinflammatory diseases.
- The role of gut bacteria in anti-NMDA receptor (NMDAR) encephalitis pathogenesis remains unclear.
- Previous studies in MS and neuromyelitis optica suggest a potential link between gut microbiota and neuroinflammation.
Purpose of the Study:
- To investigate the gut microbiota composition in patients with NMDAR encephalitis.
- To determine if specific commensal bacteria are overabundant in NMDAR encephalitis patients.
- To compare gut microbiome profiles between NMDAR encephalitis patients and healthy controls.
Main Methods:
- 16S rDNA sequencing of stool samples from 23 NMDAR encephalitis patients and 24 healthy controls.
- Analysis of intraindividual and interindividual bacterial diversity and differentially abundant taxa.
- Comparison of microbiome profiles, including specific genera and diversity metrics.
Main Results:
- No significant differences in overall gut microbiota profiles were observed between NMDAR encephalitis patients and controls.
- Subgroup analysis of patients with ovarian teratoma showed no microbiome variations.
- Transient differences in specific bacterial genera (e.g., Clostridium, Prevotella) were noted in the acute stage but lost significance after multiple testing correction.
Conclusions:
- Patients with NMDAR encephalitis exhibit a normal gut microbiome composition.
- Gut microbiome alterations are unlikely to be major contributors to NMDAR encephalitis pathogenesis, disease course, or prognosis.
- Findings suggest distinct microbiome roles in NMDAR encephalitis compared to other neuroimmunologic diseases.
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