Session Type: ACR Concurrent Abstract Session
Session Time: 2:30PM-4:00PM
The response to TNF-blockers in axial spondyloarthritis (AxSpA) is at least partially influenced by HLA-B27 through a still poorly understood mechanism. Given that HLA-B27 regulates the gut microbiota composition in rats, we seek to evaluate the predictive value of the gut microbiota composition in AxSpA patients at baseline on their subsequent responsiveness to TNF-blockers.
58 patients were recruited according to the following criteria: active disease despite NSAIDs intake; no history of inflammatory bowel disease; no antibiotics intake within 3 months prior recruitment. Bacterial 16S rRNA gene sequencing region was performed on stools samples before and after TNF-blocker treatment. Diversity metrics and custom LefSe were used to explore the relationship between the composition of the intestinal microbiota and the efficacy of TNF-blockers.
A lower alpha diversity at baseline was unexpectedly associated with better treatment response, HLA-B27 genotype and smoking behavior. Meanwhile, beta diversity was associated with smoking behavior and HLA-B27 genotype before and after treatment. Beta diversity at baseline was associated with the BASDAI index after treatment, and the response to the treatment. These results indicate a potential regulatory role for the gut microbiota on the underlying mechanisms involved in the response to TNF-blockers. Moreover, a LefSe-like approach identified 6 bacterial species as potential biomarkers for the treatment response, despite the absence of global changes (beta diversity) in the microbiota composition following a 3-month TNF-blocker intake.
The baseline composition of the gut microbiota from AxSpA patients could be associated with treatment efficacy. Further functional studies will be conducted to assess which of the aforementioned bacteria could be used as predictors of the treatment efficacy and potentially as probiotics promoting treatment efficacy among non-responders patients.
To cite this abstract in AMA style:Vallier M, Dougados M, Ferreira S, Menegatti S, Bianchi E, Rogge L, Chamaillard M, Miceli-Richard C. The Response to TNF-Blockers Treatment of Spa Patients Is Influenced By the Interplay between HLA-B27 and Gut Microbiota Composition at Baseline [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/the-response-to-tnf-blockers-treatment-of-spa-patients-is-influenced-by-the-interplay-between-hla-b27-and-gut-microbiota-composition-at-baseline/. Accessed January 21, 2020.
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