Evidence map›Paper›PMID 36870237›Full record

ArticleSeminars in arthritis and rheumatism2023

Gastrointestinal tract involvement in systemic sclerosis: The roles of diet and the microbiome.

Audrey D Nguyen, Kristofer Andréasson, Zsuzsanna H McMahan, Heather Bukiri, Natalie Howlett, Venu Lagishetty, Sungeun Melanie Lee, Jonathan P Jacobs, Elizabeth R Volkmann

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Seminars in arthritis and rheumatism, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 1 pooled it
6.1field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 2 countries.

Audrey D NguyenDivision of Rheumatology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Kristofer AndréassonDivision of Rheumatology, Lund University, Lund, Sweden.
Zsuzsanna H McMahanDivision of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Heather BukiriDivision of Rheumatology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Natalie HowlettSanta Clara Valley Medical Center, San Jose, CA, USA.
Venu LagishettyDivision of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Sungeun Melanie LeeDivision of Rheumatology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Jonathan P JacobsDivision of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Division of Gastroenterology, Hepatology and Parenteral Nutrition, Veterans Administration Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
Elizabeth R VolkmannDivision of Rheumatology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. Electronic address: evolkmann@mednet.ucla.edu.
University of California, Los Angeles · USJohns Hopkins University · USLund University · SESanta Clara Valley Medical Center · US

Funding

Identifying predictors of treatment response in systemic sclerosis-related interstitial lung diseaseK23HL150237 · NHLBI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI VOLKMANN, ELIZABETH R · 2020 to 2024
$910k
Scleroderma and Gastrointestinal Disease: Insights into Clinical Phenotypes and Disease PathogenesisK23AR071473 · NIAMS · JOHNS HOPKINS UNIVERSITY · PI MCMAHAN, ZSUZSANNA HORTOBAGYI · 2018 to 2022
$808k
CSRD VA IK2 CX001717NHLBI NIH HHS K23 HL150237NIAMS NIH HHS K23 AR071473
6 · The paper itself

Abstract

backgroundAlterations in gastrointestinal (GI) microbial composition have been reported in patients with systemic sclerosis (SSc). However, it is unclear to what degree these alterations and/or dietary changes contribute to the SSc-GI phenotype.

objectivesOur study aimed to 1) evaluate the relationship between GI microbial composition and SSc-GI symptoms, and 2) compare GI symptoms and GI microbial composition between SSc patients adhering to a low versus non-low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet.

methodsAdult SSc patients were consecutively recruited to provide stool specimens for bacterial 16S rRNA gene sequencing. Patients completed the UCLA Scleroderma Clinical Trial Consortium Gastrointestinal Tract Instrument (GIT 2.0) and the Diet History Questionnaire (DHQ) II and were classified as adhering to a low or non-low FODMAP diet. GI microbial differences were assessed using three metrics of alpha diversity (species richness, evenness, and phylogenetic diversity), as well as beta diversity (overall microbial composition). Differential abundance analysis was performed to identify specific genera associated with SSc-GI phenotype and low versus non-low FODMAP diet.

resultsOf the 66 total SSc patients included, the majority were women (n = 56) with a mean disease duration of 9.6 years. Thirty-five participants completed the DHQ II. Increased severity of GI symptoms (total GIT 2.0 score) was associated with decreased species diversity and differences in GI microbial composition. Specifically, pathobiont genera (e.g., Klebsiella and Enterococcus) were significantly more abundant in patients with increased GI symptom severity. When comparing low (N = 19) versus non-low (N = 16) FODMAP groups, there were no significant differences in GI symptom severity or in alpha and beta diversity. Compared with the low FODMAP group, the non-low FODMAP group had greater abundance of the pathobiont Enterococcus.

conclusionSSc patients reporting more severe GI symptoms exhibited GI microbial dysbiosis characterized by less species diversity and alterations in microbial composition. A low FODMAP diet was not associated with significant alterations in GI microbial composition or reduced SSc-GI symptoms; however, randomized controlled trials are needed to evaluate the impact of specific diets on GI symptoms in SSc.

Indexed as

Gastrointestinal DiseasesMicrobiotaScleroderma, SystemicDietDisaccharidesFemaleHumansMaleMonosaccharidesOligosaccharidesPhylogenyRNA, Ribosomal, 16SDisaccharidesMonosaccharidesOligosaccharidesRNA, Ribosomal, 16SFODMAP dietGastrointestinal microbiomenutritionSystemic sclerosis

Identifiers

PMID36870237
PMCPMC10148899
OpenAlexW4321793815

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.