The microbiome and systemic sclerosis: A review of current evidence

Area of Science:

• Microbiology
• Immunology
• Gastroenterology

Background:

• Systemic sclerosis (SSc) involves immune dysregulation, vasculopathy, and fibrosis, frequently affecting the gastrointestinal (GI) tract.
• GI manifestations in SSc significantly contribute to patient morbidity and mortality.
• The GI microbiome is increasingly recognized as a factor in SSc pathogenesis.

Purpose of the Study:

• To review factors influencing the GI microbiome in SSc.
• To summarize observed GI microbiome alterations in SSc patients compared to healthy controls (HC).
• To discuss potential therapeutic interventions targeting the SSc GI microbiome.

Main Methods:

• Literature review of studies investigating the GI microbiome in SSc.
• Comparative analysis of microbial taxa in SSc patients versus HC.
• Examination of associations between specific microbial genera and GI symptoms in SSc.

Main Results:

• SSc patients exhibit unique alterations in GI microbial taxa, including differences in phyla like Bacteroidetes.
• Specific genera such as Bacteroides, Clostridium, Faecalibacterium, and Lactobacillus are altered in SSc.
• Genera like Prevotella and Akkermansia have been linked to more severe GI symptoms in SSc.

Conclusions:

• The GI microbiome is significantly altered in systemic sclerosis patients.
• Microbiome alterations may be associated with disease manifestations and symptom severity.
• Targeting the GI microbiome presents a promising avenue for SSc therapeutic strategies.