July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Gut microbial dysbiosis is associated with fatigue in Behçet’s Disease.
Author Affiliations & Notes
  • Kusy Suleiman
    Academic Unit, Birmingham & Midland Eye Centre, Birmingham, West Midlands, United Kingdom
  • Liying Low
    Academic Unit, Birmingham & Midland Eye Centre, Birmingham, West Midlands, United Kingdom
  • Mariam Murad
    Academic Unit, Birmingham & Midland Eye Centre, Birmingham, West Midlands, United Kingdom
  • Mohith Shamdas
    Academic Unit, Birmingham & Midland Eye Centre, Birmingham, West Midlands, United Kingdom
  • Debbie Mitton
    Academic Unit, Birmingham & Midland Eye Centre, Birmingham, West Midlands, United Kingdom
  • Deva Situnayake
    Academic Unit, Birmingham & Midland Eye Centre, Birmingham, West Midlands, United Kingdom
  • Philip Ian Murray
    Academic Unit, Birmingham & Midland Eye Centre, Birmingham, West Midlands, United Kingdom
  • Graham R Wallace
    Academic Unit, Birmingham & Midland Eye Centre, Birmingham, West Midlands, United Kingdom
  • Saaeha Rauz
    Academic Unit, Birmingham & Midland Eye Centre, Birmingham, West Midlands, United Kingdom
  • Footnotes
    Commercial Relationships   Kusy Suleiman, None; Liying Low, None; Mariam Murad, None; Mohith Shamdas, None; Debbie Mitton, None; Deva Situnayake, None; Philip Murray, None; Graham Wallace, None; Saaeha Rauz, None
  • Footnotes
    Support  1. Sir Arthur Thomson Charitable Trust Vacation Studentship (for Kusy Suleiman) 2. Fight for Sight Clinical Fellowship Funding (for Liying Low)
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 2521. doi:
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      Kusy Suleiman, Liying Low, Mariam Murad, Mohith Shamdas, Debbie Mitton, Deva Situnayake, Philip Ian Murray, Graham R Wallace, Saaeha Rauz; Gut microbial dysbiosis is associated with fatigue in Behçet’s Disease.. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2521.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The gut microbiota is important in the regulation of energy haemostasis and modulation of the immune system. This study tested the hypothesis that alterations in the gut microbiota is associated with fatigue in patients with Behçet’s Disease (BD).

Methods : Patients with BD fulfilling the Behçet’s Syndrome International Study Group criteria were recruited to the study, along with disease and healthy controls. Mucous Membrane Pemphigoid (MMP) was used as disease control as it is a multisystem disease with mucocutaneous involvement, similar to BD.

Participants completed the Modified Fatigue Impact Scale(MFIS) questionnaire which assessed the effects of fatigue on physical, cognitive and psychosocial functioning. Based on the total MFIS scores, participants were divided into a Low Fatigue Group (LFG) and High Fatigue Group (HFG).

The V4 region of the 16S rRNA gene of bacterial DNA from fresh faecal samples was amplified and sequenced on Illumina MiSeq. Microbial 16S sequence data was analysed using Quantitative Insights Into Microbial Ecology (QIIME) and Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt) software.

To reduce potential dietary bias, a weekly food-frequency questionnaire was administered. C-reactive protein levels were used as marker for systemic inflammatory status.

Results : A total of 65 participants were recruited to the study [BD (n=32); MMP (n= 13); HC (n=10)]. Patients with BD reported higher scores in all components of the MFIS [MFIS Physical (BD: median:25, interquartile range (IQR) 18-32; MMP: 19, 16-28; HC: 6, 0-11) (p=<0.0001); MFIS Cognitive (BD: 23, 16-29; MMP: 13, 6-17; HC: 11, 6-17) (p<0.0001); MFIS Psychosocial (BD: 5, 4-7; MMP: 4, 3-7; HC: 1, 0-3) (p<0.0001)].

The dominant phyla were Firmicutes (LFG : 47.1±6.3%; HFG: 58.5±2.0%) and Bacteroides (LFG: 24.6±8.8%; HFG: 8.1±3.0%) followed by Verrucomicrobia (LFG: 10.5±0.0%; HFG: 3.9±0.0%) and Actinobacteria (LFG: 4.9±2.0%; HFG: 7.0±2.2%).

Predictive functional profile of the gut microbiome of patients in the HFG group had a lower relative abundance of bacterial genes related to protein processing in endoplasmic reticulum (p<0.0001) and PPAR signalling pathway (p<0.0001), known to be important in the regulation of lipid metabolism and gluconeogenesis.

Conclusions : Dysbiosis in the predicted functional profile of gut microbiome is associated with higher levels of fatigue in BD.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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