Observational studyThe Journal of clinical endocrinology and metabolism2023
Gut Microbiome Associated With Graves Disease and Graves Orbitopathy: The INDIGO Multicenter European Study.
Observational study in The Journal of clinical endocrinology and metabolism, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 49 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
49 citing papers in PubMed, 1 synthesis or guideline pooled it, 60 citations in OpenAlex.
- Multi-Omics Approaches to Discover Biomarkers of Thyroid Eye Disease: A Systematic Review.International journal of biological sciences · 2024Pooled it
- Mediterranean diet, selenium and Graves' ophthalmopathy: a prospective, randomized, single-center study.Endocrine · 2025Trial
- Role of sex and gender in autoimmune thyroid diseases: mechanisms and knowledge gaps.Reviews in endocrine & metabolic disorders · 2026Review
- The role of gut microbiota in thyroid cancer: from pathogenesis to diagnosis and treatment.Journal of endocrinological investigation · 2026Review
- Gut Microbial Metabolite Indole-3-Acetic Acid Exerts Protective Effects by Regulating Orbital Fibroblast Fibrosis in Thyroid Eye Disease.Investigative ophthalmology & visual science · 2026Article
- Gut and Orbital Dysbiosis Associated with Graves' Disease and Graves' Orbitopathy: A Systematic Review.Journal of clinical medicine · 2026Review
- Gut Microbiota and Thyroid Diseases.The Eurasian journal of medicine · 2026Article
- Review
- Association between gut microbiota and chronic diseases in East Asian ethnicity: A two-sample Mendelian randomization study.Medicine · 2026Observational
- The Broad Effect of Iodine in Graves' Hyperthyroidism and Its Relationship with the Gut Microbiota.Nutrients · 2026Review
- What has changed in thyroid eye disease in the last five years (2020-2025).European thyroid journal · 2026Review
- Integrative analysis of gut microbiota, plasma metabolome, and gene expression identifies causal mediators in Graves' disease pathogenesis.Frontiers in microbiology · 2026Article
- Gut microbiota and its metabolites with thyroid diseases: functions and mechanisms.Frontiers in immunology · 2026Review
- Changes in gut microbiota before and after treatment in patients with primary hypothyroidism.Open life sciences · 2026Article
- Vitamin D and gut microbiota in thyroid diseases: mechanisms and therapeutic potential.Frontiers in immunology · 2026Review
- The gut microbiota in Graves' disease: mechanistic insights and clinical implications.Frontiers in cellular and infection microbiology · 2026Review
- Modulation of gut microbiota in Graves' orbitopathy: Prevotella dominance and atorvastatin's impact.Microbiome · 2025Article
- Autoimmune Thyroid Diseases and Microscopic Colitis: A Nationwide Matched Case-Control Study in Sweden.The Journal of clinical endocrinology and metabolism · 2025Article
- Unravelling the pathogenic mechanisms in Graves' orbitopathy.European thyroid journal · 2025Review
- Tryptophan metabolites exert potential therapeutic activity in graves' orbitopathy by ameliorating orbital fibroblasts inflammation and proliferation.Journal of endocrinological investigation · 2025Article
Corrections and comments
- Erratum issued
Authors and funding
20 authors at 12 institutions in 5 countries.
Funding
Abstract
contextGut bacteria can influence host immune responses but little is known about their role in tolerance-loss mechanisms in Graves disease (GD; hyperthyroidism caused by autoantibodies, TRAb, to the thyrotropin receptor, TSHR) and its progression to Graves orbitopathy (GO).
objectiveThis work aimed to compare the fecal microbiota in GD patients, with GO of varying severity, and healthy controls (HCs).
methodsPatients were recruited from 4 European countries (105 GD patients, 41 HCs) for an observational study with cross-sectional and longitudinal components.
resultsAt recruitment, when patients were hyperthyroid and TRAb positive, Actinobacteria were significantly increased and Bacteroidetes significantly decreased in GD/GO compared with HCs. The Firmicutes to Bacteroidetes (F:B) ratio was significantly higher in GD/GO than in HCs. Differential abundance of 15 genera was observed in patients, being most skewed in mild GO. Bacteroides displayed positive and negative correlations with TSH and free thyroxine, respectively, and was also significantly associated with smoking in GO; smoking is a risk factor for GO but not GD. Longitudinal analyses revealed that the presence of certain bacteria (Clostridiales) at diagnosis correlated with the persistence of TRAb more than 200 days after commencing antithyroid drug treatment.
conclusionThe increased F:B ratio observed in GD/GO mirrors our finding in a murine model comparing TSHR-immunized with control mice. We defined a microbiome signature and identified changes associated with autoimmunity as distinct from those due to hyperthyroidism. Persistence of TRAb is predictive of relapse; identification of these patients at diagnosis, via their microbiome, could improve management with potential to eradicate Clostridiales.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.