Open AccessGut microbiome is associated with multiple sclerosis activity in children
Author(s) -
Horton Mary K.,
McCauley Kathryn,
Fadrosh Douglas,
Fujimura Kei,
Graves Jennifer,
Ness Jayne,
Wheeler Yolanda,
Gorman Mark P.,
Benson Leslie A.,
WeinstockGuttman Bianca,
Waldman Amy,
Rodriguez Moses,
Tillema JanMendelt,
Krupp Lauren,
Belman Anita,
Mar Soe,
Rensel Mary,
Chitnis Tanuja,
Casper Theron Charles,
Rose John,
Hart Janace,
Shao Xiaorong,
Tremlett Helen,
Lynch Susan V.,
Barcellos Lisa F.,
Waubant Emmanuelle
Publication year - 2021
Publication title -
annals of clinical and translational neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.824
H-Index - 42
ISSN - 2328-9503
DOI - 10.1002/acn3.51441
Subject(s) - hazard ratio , medicine , confidence interval , microbiome , multiple sclerosis , clinically isolated syndrome , proportional hazards model , metagenomics , bioinformatics , immunology , biology , genetics , gene
Objective To identify features of the gut microbiome associated with multiple sclerosis activity over time. Methods We used 16S ribosomal RNA sequencing from stool of 55 recently diagnosed pediatric‐onset multiple sclerosis patients. Microbiome features included the abundance of individual microbes and networks identified from weighted genetic correlation network analyses. Prentice‐Williams‐Peterson Cox proportional hazards models estimated the associations between features and three disease activity outcomes: clinical relapses and both new/enlarging T2 lesions and new gadolinium‐enhancing lesions on brain MRI. Analyses were adjusted for age, sex, and disease‐modifying therapies. Results Participants were followed, on average, 2.1 years. Five microbes were nominally associated with all three disease activity outcomes after multiple testing correction. These included butyrate producers Odoribacter (relapse hazard ratio = 0.46, 95% confidence interval: 0.24, 0.88) and Butyricicoccus (relapse hazard ratio = 0.49, 95% confidence interval: 0.28, 0.88). Two networks of co‐occurring gut microbes were significantly associated with a higher hazard of both MRI outcomes (gadolinium‐enhancing lesion hazard ratios (95% confidence intervals) for Modules 32 and 33 were 1.29 (1.08, 1.54) and 1.42 (1.18, 1.71), respectively; T2 lesion hazard ratios (95% confidence intervals) for Modules 32 and 33 were 1.34 (1.15, 1.56) and 1.41 (1.21, 1.64), respectively). Metagenomic predictions of these networks demonstrated enrichment for amino acid biosynthesis pathways. Interpretation Both individual and networks of gut microbes were associated with longitudinal multiple sclerosis activity. Known functions and metagenomic predictions of these microbes suggest the important role of butyrate and amino acid biosynthesis pathways. This provides strong support for future development of personalized microbiome interventions to modify multiple sclerosis disease activity.