Ileal Mucosa-Associated Microbiota Overgrowth Associated with Diagnosis and Pathogenesis of Primary Biliary Cholangitis
Abstract Background The gut microbiota has potential implications in the pathogenesis of primary biliary cholangitis (PBC). However, little is known about the significance of small intestinal mucosa-associated microbiota (MAM) in PBC. We aimed to investigate the ileal MAM profile and identify its association with liver pathology in patients with PBC. Methods Forty-three patients with PBC and 24 healthy controls who underwent colonoscopy at our hospital between March 2018 and January 2020 were enrolled in a cross-sectional study. We performed 16S ribosomal RNA gene sequencing of MAM samples obtained from the mucosa of the terminal ileum of all subjects. We also examined the relationship between the abundance of ileal MAM and chronic nonsuppurative destructive cholangitis using liver specimens from patients with PBC. Results Dysbiosis of ileal MAM was observed in patients with PBC, with a characteristic overgrowth of Sphingomonadaceae and Pseudomonas. Multivariate analysis showed that the overgrowth of Sphingomonadaceae and Pseudomonas is an independent association factor for PBC. Moreover, the abundance of Sphingomonadaceae was associated with chronic nonsuppurative destructive cholangitis in PBC. Conclusions Overgrowth of Sphingomonadaceae and Pseudomonas in ileal MAM is an independent association factor for diagnosing PBC. Sphingomonadaceae may be particularly associated with the pathological development of PBC.