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Peters BA, Hanna DB, Xue X, Weber K, Appleton AA, Kassaye SG, Topper E, Tracy RP, Guillemette C, Caron P, Tien PC, Qi Q, Burk RD, Sharma A, Anastos K, Kaplan RC. Menopause and Estrogen Associations With Gut Barrier, Microbial Translocation, and Immune Activation Biomarkers in Women With and Without HIV. J Acquir Immune Defic Syndr 2024; 96:214-222. [PMID: 38905473 PMCID: PMC11196004 DOI: 10.1097/qai.0000000000003419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/29/2024] [Indexed: 06/23/2024]
Abstract
OBJECTIVES Estrogens may protect the gut barrier and reduce microbial translocation and immune activation, which are prevalent in HIV infection. We investigated relationships of the menopausal transition and estrogens with gut barrier, microbial translocation, and immune activation biomarkers in women with and without HIV. DESIGN Longitudinal and cross-sectional studies nested in the Women's Interagency HIV Study. METHODS Intestinal fatty acid binding protein, lipopolysaccharide binding protein, and soluble CD14 (sCD14) levels were measured in serum from 77 women (43 with HIV) before, during, and after the menopausal transition (∼6 measures per woman over ∼13 years). A separate cross-sectional analysis was conducted among 72 postmenopausal women with HIV with these biomarkers and serum estrogens. RESULTS Women in the longitudinal analysis were a median age of 43 years at baseline. In piecewise, linear, mixed-effects models with cutpoints 2 years before and after the final menstrual period to delineate the menopausal transition, sCD14 levels increased over time during the menopausal transition (Beta [95% CI]: 38 [12 to 64] ng/mL/yr, P = 0.004), followed by a decrease posttransition (-46 [-75 to -18], P = 0.001), with the piecewise model providing a better fit than a linear model (P = 0.0006). In stratified analyses, these results were only apparent in women with HIV. In cross-sectional analyses, among women with HIV, free estradiol inversely correlated with sCD14 levels (r = -0.26, P = 0.03). Lipopolysaccharide binding protein and intestinal fatty acid binding protein levels did not appear related to the menopausal transition and estrogen levels. CONCLUSIONS Women with HIV may experience heightened innate immune activation during menopause, possibly related to the depletion of estrogens.
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Affiliation(s)
- Brandilyn A. Peters
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - David B. Hanna
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Xiaonan Xue
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Kathleen Weber
- Cook County Health/Hektoen Institute of Medicine, Chicago, IL, USA
| | - Allison A. Appleton
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Rensselaer, NY, United States
| | | | - Elizabeth Topper
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Russell P. Tracy
- Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, VT, USA
| | - Chantal Guillemette
- Centre Hospitalier Universitaire (CHU) de Québec - Université Laval Research Center, Cancer research center (CRC) and Faculty of Pharmacy, Université Laval, Québec City, QC, Canada
| | - Patrick Caron
- Centre Hospitalier Universitaire (CHU) de Québec - Université Laval Research Center, Cancer research center (CRC) and Faculty of Pharmacy, Université Laval, Québec City, QC, Canada
| | - Phyllis C. Tien
- Department of Veterans Affairs Medical Center, San Francisco, CA, USA
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Qibin Qi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Robert D. Burk
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
- Departments of Microbiology and Immunology and Obstetrics & Gynecology and Women’s Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Anjali Sharma
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Kathryn Anastos
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Robert C. Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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Gilbert BTP, Tadeo RYT, Lamacchia C, Studer O, Courvoisier D, Raes J, Finckh A. Gut microbiome and intestinal inflammation in preclinical stages of rheumatoid arthritis. RMD Open 2024; 10:e003589. [PMID: 38296308 PMCID: PMC10836359 DOI: 10.1136/rmdopen-2023-003589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 01/15/2024] [Indexed: 02/05/2024] Open
Abstract
BACKGROUND Faecal Prevotellaceae, and other microbes, have been associated with rheumatoid arthritis (RA) and preclinical RA. We have performed a quantitative microbiome profiling study in preclinical stages of RA. METHODS First-degree relatives of patients with RA (RA-FDRs) from the SCREEN-RA cohort were categorised into four groups: controls, healthy asymptomatic RA-FDRs; high genetic risk, asymptomatic RA-FDRs with two copies of the shared epitope; autoimmunity, asymptomatic RA-FDRs with RA-associated autoimmunity; and symptomatic, clinically suspect arthralgias or untreated new-onset RA.Faecal samples were collected and frozen. 16S sequencing was performed, processed with DADA2 pipeline and Silva database. Cell counts (cytometry) and faecal calprotectin (enzyme-linked immunosorbent assay, ELISA) were also obtained. Microbial community analyses were conducted using non-parametric tests, such as permutational multivariate analysis of variance (PERMANOVA), Wilcoxon and Kruskal-Wallis, or Aldex2. RESULTS A total of 371 individuals were included and categorised according to their preclinical stage of the disease. Groups had similar age, gender and body mass index. We found no significant differences in the quantitative microbiome profiles by preclinical stages (PERMANOVA, R2=0.00798, p=0.56) and, in particular, no group differences in Prevotellaceae abundance. Results were similar when using relative microbiome profiling data (PERMANOVA, R2=0.0073, p=0.83) or Aldex2 on 16S sequence counts. Regarding faecal calprotectin, we found no differences between groups (p=0.3). CONCLUSIONS We could not identify microbiome profiles associated with preclinical stages of RA. Only in a subgroup of individuals with the most pronounced phenotypes did we modestly retrieve the previously reported associations.
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Affiliation(s)
- Benoît Thomas P Gilbert
- Division of Rheumatology, HUG, Geneva, Switzerland
- Geneva Centre for Inflammation Research, UNIGE, Geneva, Switzerland
| | - Raul Yhossef Tito Tadeo
- KU Leuven, Department of Microbiology, Immunology, and Transplantation, Rega Institute for Medical Research, B-3000 Leuven, Belgium
- VIB, Center for Microbiology, B-3000 Leuven, Belgium
| | - Celine Lamacchia
- Division of Rheumatology, HUG, Geneva, Switzerland
- Geneva Centre for Inflammation Research, UNIGE, Geneva, Switzerland
| | - Olivia Studer
- Division of Rheumatology, HUG, Geneva, Switzerland
- Geneva Centre for Inflammation Research, UNIGE, Geneva, Switzerland
| | - Delphine Courvoisier
- Division of Rheumatology, HUG, Geneva, Switzerland
- Geneva Centre for Inflammation Research, UNIGE, Geneva, Switzerland
| | - Jeroen Raes
- KU Leuven, Department of Microbiology, Immunology, and Transplantation, Rega Institute for Medical Research, B-3000 Leuven, Belgium
- VIB, Center for Microbiology, B-3000 Leuven, Belgium
| | - Axel Finckh
- Division of Rheumatology, HUG, Geneva, Switzerland
- Geneva Centre for Inflammation Research, UNIGE, Geneva, Switzerland
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Heidt C, Kämmerer U, Fobker M, Rüffer A, Marquardt T, Reuss-Borst M. Assessment of Intestinal Permeability and Inflammation Bio-Markers in Patients with Rheumatoid Arthritis. Nutrients 2023; 15:nu15102386. [PMID: 37242269 DOI: 10.3390/nu15102386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/27/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023] Open
Abstract
Increased intestinal permeability and inflammation, both fueled by dysbiosis, appear to contribute to rheumatoid arthritis (RA) pathogenesis. This single-center pilot study aimed to investigate zonulin, a marker of intestinal permeability, and calprotectin, a marker of intestinal inflammation, measured in serum and fecal samples of RA patients using commercially available kits. We also analyzed plasma lipopolysaccharide (LPS) levels, a marker of intestinal permeability and inflammation. Furthermore, univariate, and multivariate regression analyses were carried out to determine whether or not there were associations of zonulin and calprotectin with LPS, BMI, gender, age, RA-specific parameters, fiber intake, and short-chain fatty acids in the gut. Serum zonulin levels were more likely to be abnormal with a longer disease duration and fecal zonulin levels were inversely associated with age. A strong association between fecal and serum calprotectin and between fecal calprotectin and LPS were found in males, but not in females, independent of other biomarkers, suggesting that fecal calprotectin may be a more specific biomarker than serum calprotectin is of intestinal inflammation in RA. Since this was a proof-of-principle study without a healthy control group, further research is needed to validate fecal and serum zonulin as valid biomarkers of RA in comparison with other promising biomarkers.
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Affiliation(s)
- Christina Heidt
- University of Muenster, D-48149 Muenster, Germany
- Department of General Pediatrics, Metabolic Diseases, University of Muenster, Albert-Schweitzer-Campus, D-48149 Muenster, Germany
| | - Ulrike Kämmerer
- Department of Obstetrics and Gynaecology, University Hospital of Wuerzburg, D-97080 Wuerzburg, Germany
| | - Manfred Fobker
- Centre of Laboratory Medicine, University Hospital Muenster, D-48149 Muenster, Germany
| | | | - Thorsten Marquardt
- Department of General Pediatrics, Metabolic Diseases, University of Muenster, Albert-Schweitzer-Campus, D-48149 Muenster, Germany
| | - Monika Reuss-Borst
- Hescuro Center for Rehabilitation and Prevention Bad Bocklet, D-97708 Bad Bocklet, Germany
- Department of Nephrology and Rheumatology, Georg-August University of Goettingen, D-37075 Goettingen, Germany
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