Gut microbiome dysbiosis is associated with lumbar degenerative spondylolisthesis in symptomatic patients

IF 3.4 3区医学 Q1 ORTHOPEDICS

JOR Spine Pub Date : 2024-10-10 DOI:10.1002/jsp2.70005

Khaled Aboushaala, Ana V. Chee, Darbaz Adnan, Sheila J. Toro, Harmanjeet Singh, Andrew Savoia, Ekamjeet S. Dhillon, Catherine Yuh, Jake Dourdourekas, Ishani K. Patel, Rajko Vucicevic, Alejandro A. Espinoza-Orias, John T. Martin, Chundo Oh, Ali Keshavarzian, Hanne B. Albert, Jaro Karppinen, Mehmet Kocak, Arnold Y. L. Wong, Edward J. Goldberg, Frank M. Phillips, Matthew W. Colman, Frances M. K. Williams, Jeffrey A. Borgia, Ankur Naqib, Stefan J. Green, Christopher B. Forsyth, Howard S. An, Dino Samartzis

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Abstract

Background

Lumbar degenerative spondylolisthesis (LDS), characterized as degeneration of the intervertebral disc and structural changes of the facet joints, is a condition with varying degrees of instability that may lead to pain, canal stenosis, and subsequent surgical intervention. However, the etiology of LDS remains inconclusive. Gut microbiome dysbiosis may stimulate systemic inflammation in various disorders. However, the role of such dysbiosis upon spine health remains under-studied. The current study assessed the association of gut microbiome dysbiosis in symptomatic patients with or without LDS.

Methods

A cross-sectional analysis within the framework of a prospective study was performed. DNA was extracted from fecal samples collected from adult symptomatic patients with (n = 21) and without LDS (n = 12). Alpha and beta diversity assessed differences in fecal microbial community between groups. Taxon-by-taxon analysis identified microbial features with differential relative abundance between groups. Subject demographics and imaging parameters were also assessed.

Results

There was no significant group differences in age, sex, race, body mass index, smoking/alcohol history, pain profiles, spinopelvic alignment, and Modic changes (p >0.05). LDS subjects had significantly higher disc degeneration severity (p = 0.018) and alpha diversity levels compared to non-LDS subjects (p = 0.002–0.003). Significant differences in gut microbial community structure were observed between groups (p = 0.046). Subjects with LDS exhibited distinct differences at the phylum level, with a significantly higher Firmicutes to Bacteroidota ratio compared to non-LDS (p = 0.003). Differential relative abundance analysis identified six taxa with significant differences between the two groups, with LDS demonstrating an increase in putative pro-inflammatory bacteria (Dialister, CAG-352) and a decrease in anti-inflammatory bacteria (Slackia, Escherichia-Shigella).

Conclusion

This study is the first to report a significant association of gut microbiome dysbiosis and LDS in symptomatic patients, noting pro-inflammatory bacterial taxa. This work provides a foundation for future studies addressing the role of the gut microbiome in association with spine health and disease.

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肠道微生物群失调与有症状患者的腰椎退行性滑脱症有关

背景腰椎退行性滑脱症（LDS）以椎间盘退变和面关节结构改变为特征，是一种具有不同程度不稳定性的疾病，可能导致疼痛、椎管狭窄和随后的手术干预。然而，LDS 的病因仍无定论。肠道微生物群失调可能会在各种疾病中刺激全身炎症。然而，这种菌群失调对脊柱健康的影响仍未得到充分研究。本研究评估了有症状或无 LDS 的患者肠道微生物群失调的相关性。方法在前瞻性研究框架内进行横断面分析。从有症状的成年 LDS 患者（21 人）和无 LDS 的患者（12 人）的粪便样本中提取 DNA。α和β多样性评估了组间粪便微生物群落的差异。逐类群分析确定了组间相对丰度不同的微生物特征。此外，还对受试者的人口统计学特征和成像参数进行了评估。结果各组在年龄、性别、种族、体重指数、吸烟/饮酒史、疼痛特征、脊柱排列和 Modic 变化方面无明显差异（p >0.05）。与非 LDS 受试者相比，LDS 受试者的椎间盘变性严重程度（p = 0.018）和α多样性水平（p = 0.002-0.003）明显更高。各组之间的肠道微生物群落结构存在明显差异（p = 0.046）。与非 LDS 受试者相比，患有 LDS 的受试者在门类水平上表现出明显的差异，固着菌与类杆菌的比例明显更高（p = 0.003）。差异相对丰度分析确定了两组之间存在显著差异的 6 个分类群，其中 LDS 表明假定的促炎细菌（Dialister、CAG-352）增加，而抗炎细菌（Slackia、Escherichia-Shigella）减少。结论本研究首次报告了有症状患者的肠道微生物群失调与 LDS 的显著关联，并指出了促炎细菌类群。这项工作为今后研究肠道微生物组在脊柱健康和疾病中的作用奠定了基础。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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