Prospective Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2019; 7(18): 2734-2745
Published online Sep 26, 2019. doi: 10.12998/wjcc.v7.i18.2734
Characterization of microbiota in systemic-onset juvenile idiopathic arthritis with different disease severities
Yan-Qing Dong, Wei Wang, Ji Li, Ming-Sheng Ma, Lin-Qing Zhong, Qi-Jiao Wei, Hong-Mei Song
Yan-Qing Dong, Wei Wang, Ji Li, Ming-Sheng Ma, Lin-Qing Zhong, Qi-Jiao Wei, Hong-Mei Song, Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Author contributions: All authors helped to perform the research; Dong YQ, Wang W, and Song HM contributed to the study conception and design, performing of the procedures, manuscript writing, and data analysis; Li J and Ma MS contributed to data acquisition and performing of the procedures; Zhong LQ and Wei QJ contributed to data analysis and article editing and reviewing.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College.
Informed consent statement: Written informed consent was obtained from one of the parents of each participant on the day of sample collection.
Conflict-of-interest statement: All authors declare no conflicts of interest related to this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Hong-Mei Song, MD, PhD, Chief Doctor, Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1, Shuaifuyuan Road, Beijing 100730, China. songhm1021@hotmail.com
Telephone: +86-10-69156271 Fax: +86-10-69156271
Received: March 29, 2019
Peer-review started: April 4, 2019
First decision: June 19, 2019
Revised: July 17, 2019
Accepted: July 27, 2019
Article in press: July 27, 2019
Published online: September 26, 2019
ARTICLE HIGHLIGHTS
Research background

Systemic-onset juvenile idiopathic arthritis (SoJIA) is a serious chronic rheumatic disease of childhood. The pathogenesis of SoJIA remains unclear, and several studies suggest that perturbation of gut microbiota, dysbiosis, could contribute to development of JIA. Understanding the intestinal microbial characteristics may contribute to the prevention and treatment of SoJIA.

Research motivation

We aimed to characterize the gut microbiota in SoJIA and to analyze the changing trend of intestinal flora as the disease improved.

Research objectives

Our main purpose was to characterize the gut microbiota in SoJIA and investigate the correlation between the abundance of intestinal microorganisms and clinical indicators as well as the pathogenesis of SoJIA from the perspective of microorganisms.

Research methods

We carried out an observational single-center study. A total of 32 patients and 32 healthy children were enrolled. The patients were divided into two groups: Active-SoJIA and Inactive-SoJIA. Clinical data and stool samples were collected from SoJIA patients when they visited the hospital.

Research results

Alpha-diversity analysis indicated that there was an increased richness in the microbiota of SoJIA patients. Measures of beta-diversity showed that characteristics of gut microbiota of both SoJIA samples (active and inactive) were more similar to each other than to the control group. The Firmicutes/Bacteroidetes ratio and the abundance of Erysipelotrichales, Ruminococcaceae, and Faecalibacterium were decreased in SoJIA. By contrast, the abundance of Bacteroides and Bacteroidaceae was increased in SoJIA. The Firmicutes/Bacteroidetes ratio and other bacterial abundance in the Inactive-SoJIA group were at a moderate level between the Active-SoJIA group and healthy children. Proteobacteria and Enterobacteriaceae were negatively correlated with disease activity.

Research conclusions

The composition of the intestinal microbiota is different in SoJIA patients compared to healthy children. The perturbed microbiota demonstrated partial restoration in inactive status patients after treatment.

Research perspectives

There are many factors affecting gut microbiota composition. Future studies should prospectively collect multicenter data on new-onset SoJIA patients, and analyze the changing trend of intestinal flora of each patient as the disease improves to eliminate the interference of geographical, environmental, or dietary habits on intestinal flora.