Modulating gut microbiota in a mouse model of Graves' orbitopathy and its impact on induced disease.

Graves’ disease Graves’ orbitopathy Gut microbiota Human fecal microbiota transplant Microbiome modulation Murine model Probiotics Vancomycin

Journal

Microbiome
ISSN: 2049-2618
Titre abrégé: Microbiome
Pays: England
ID NLM: 101615147

Informations de publication

Date de publication:
16 02 2021
Historique:
received: 05 11 2020
accepted: 06 12 2020
entrez: 17 2 2021
pubmed: 18 2 2021
medline: 19 3 2021
Statut: epublish

Résumé

Graves' disease (GD) is an autoimmune condition in which autoantibodies to the thyrotropin receptor (TSHR) cause hyperthyroidism. About 50% of GD patients also have Graves' orbitopathy (GO), an intractable disease in which expansion of the orbital contents causes diplopia, proptosis and even blindness. Murine models of GD/GO, developed in different centres, demonstrated significant variation in gut microbiota composition which correlated with TSHR-induced disease heterogeneity. To investigate whether correlation indicates causation, we modified the gut microbiota to determine whether it has a role in thyroid autoimmunity. Female BALB/c mice were treated with either vancomycin, probiotic bacteria, human fecal material transfer (hFMT) from patients with severe GO or ddH2O from birth to immunization with TSHR-A subunit or beta-galactosidase (βgal; age ~ 6 weeks). Incidence and severity of GD (TSHR autoantibodies, thyroid histology, thyroxine level) and GO (orbital fat and muscle histology), lymphocyte phenotype, cytokine profile and gut microbiota were analysed at sacrifice (~ 22 weeks). In ddH2O-TSHR mice, 84% had pathological autoantibodies, 67% elevated thyroxine, 77% hyperplastic thyroids and 70% orbital pathology. Firmicutes were increased, and Bacteroidetes reduced relative to ddH2O-βgal; CCL5 was increased. The random forest algorithm at the genus level predicted vancomycin treatment with 100% accuracy but 74% and 70% for hFMT and probiotic, respectively. Vancomycin significantly reduced gut microbiota richness and diversity compared with all other groups; the incidence and severity of both GD and GO also decreased; reduced orbital pathology correlated positively with Akkermansia spp. whilst IL-4 levels increased. Mice receiving hFMT initially inherited their GO donors' microbiota, and the severity of induced GD increased, as did the orbital brown adipose tissue volume in TSHR mice. Furthermore, genus Bacteroides, which is reduced in GD patients, was significantly increased by vancomycin but reduced in hFMT-treated mice. Probiotic treatment significantly increased CD25 These results strongly support a role for the gut microbiota in TSHR-induced disease. Whilst changes to the gut microbiota have a profound effect on quantifiable GD endocrine and immune factors, the impact on GO cellular changes is more nuanced. The findings have translational potential for novel, improved treatments. Video abstract.

Sections du résumé

BACKGROUND
Graves' disease (GD) is an autoimmune condition in which autoantibodies to the thyrotropin receptor (TSHR) cause hyperthyroidism. About 50% of GD patients also have Graves' orbitopathy (GO), an intractable disease in which expansion of the orbital contents causes diplopia, proptosis and even blindness. Murine models of GD/GO, developed in different centres, demonstrated significant variation in gut microbiota composition which correlated with TSHR-induced disease heterogeneity. To investigate whether correlation indicates causation, we modified the gut microbiota to determine whether it has a role in thyroid autoimmunity. Female BALB/c mice were treated with either vancomycin, probiotic bacteria, human fecal material transfer (hFMT) from patients with severe GO or ddH2O from birth to immunization with TSHR-A subunit or beta-galactosidase (βgal; age ~ 6 weeks). Incidence and severity of GD (TSHR autoantibodies, thyroid histology, thyroxine level) and GO (orbital fat and muscle histology), lymphocyte phenotype, cytokine profile and gut microbiota were analysed at sacrifice (~ 22 weeks).
RESULTS
In ddH2O-TSHR mice, 84% had pathological autoantibodies, 67% elevated thyroxine, 77% hyperplastic thyroids and 70% orbital pathology. Firmicutes were increased, and Bacteroidetes reduced relative to ddH2O-βgal; CCL5 was increased. The random forest algorithm at the genus level predicted vancomycin treatment with 100% accuracy but 74% and 70% for hFMT and probiotic, respectively. Vancomycin significantly reduced gut microbiota richness and diversity compared with all other groups; the incidence and severity of both GD and GO also decreased; reduced orbital pathology correlated positively with Akkermansia spp. whilst IL-4 levels increased. Mice receiving hFMT initially inherited their GO donors' microbiota, and the severity of induced GD increased, as did the orbital brown adipose tissue volume in TSHR mice. Furthermore, genus Bacteroides, which is reduced in GD patients, was significantly increased by vancomycin but reduced in hFMT-treated mice. Probiotic treatment significantly increased CD25
CONCLUSIONS
These results strongly support a role for the gut microbiota in TSHR-induced disease. Whilst changes to the gut microbiota have a profound effect on quantifiable GD endocrine and immune factors, the impact on GO cellular changes is more nuanced. The findings have translational potential for novel, improved treatments. Video abstract.

Identifiants

pubmed: 33593429
doi: 10.1186/s40168-020-00952-4
pii: 10.1186/s40168-020-00952-4
pmc: PMC7888139
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Video-Audio Media

Langues

eng

Sous-ensembles de citation

IM

Pagination

45

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Auteurs

Sajad Moshkelgosha (S)

Molecular Ophthalmology, Department of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany.
Current address: Latner Thoracic Surgery Laboratories, Toronto General Research Institute, University Health Network and University of Toronto, Toronto, Canada.

Hedda Luise Verhasselt (HL)

Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Cultech Ltd., Baglan, Port Talbot, UK.

Giulia Masetti (G)

Division of Infection & Immunity, School of Medicine, Cardiff University, UHW main building, Heath Park, Cardiff, CF14 4XW, UK.
Department of Bioinformatics, PTP Science Park Srl, Lodi, Italy.
Current address: Computational metagenomics, Department CIBIO, University of Trento, Trento, Italy.

Danila Covelli (D)

Cultech Ltd., Baglan, Port Talbot, UK.
Graves' Orbitopathy Center, Endocrinology, Department of Clinical Sciences and Community Health, Fondazione Ca'Granda IRCCS, University of Milan, Milan, Italy.

Filippo Biscarini (F)

Department of Bioinformatics, PTP Science Park Srl, Lodi, Italy.
Italian National Research Council (CNR), Milano, Italy.

Mareike Horstmann (M)

Molecular Ophthalmology, Department of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany.

Anke Daser (A)

Department of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany.

Astrid M Westendorf (AM)

Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.

Christoph Jesenek (C)

Molecular Ophthalmology, Department of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany.

Svenja Philipp (S)

Molecular Ophthalmology, Department of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany.

Salvador Diaz-Cano (S)

Department of Histopathology, King's College Hospital, King's College, London, UK.

J Paul Banga (JP)

Molecular Ophthalmology, Department of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany.

Daryn Michael (D)

Cultech Ltd., Baglan, Port Talbot, UK.

Sue Plummer (S)

Cultech Ltd., Baglan, Port Talbot, UK.

Julian R Marchesi (JR)

School of Biosciences, Cardiff University, Cardiff, UK.
Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.

Anja Eckstein (A)

Department of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany. Anja.Eckstein@uk-essen.de.

Marian Ludgate (M)

Division of Infection & Immunity, School of Medicine, Cardiff University, UHW main building, Heath Park, Cardiff, CF14 4XW, UK. Ludgate@cardiff.ac.uk.

Utta Berchner-Pfannschmidt (U)

Molecular Ophthalmology, Department of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany. Utta.Berchner-Pfannschmidt@uk-essen.de.

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