Published online Jun 15, 2023. doi: 10.4239/wjd.v14.i6.862
Peer-review started: March 9, 2023
First decision: March 23, 2023
Revised: April 9, 2023
Accepted: April 27, 2023
Article in press: April 27, 2023
Published online: June 15, 2023
Processing time: 98 Days and 0.6 Hours
For the therapy of diabetic retinopathy (DR), current approaches showed their own limitations. Modulation of gut flora was capable of preventing DR, which was revealed by animal experiment.
To provide clues for novel ways to prevention and treatment methods of DR.
This study aims to explore the relationship between intestinal microbiota and DR among patients in the southeast coast of China.
By 16S rRNA sequencing, fecal samples of non-diabetics (Group C, n = 15) and diabetics (Group DM, n = 30) were analyzed. Spearman correlation analyses were performed to explore the associations between intestinal microbiota and clinical indicators.
The alpha and beta diversity did not differ significantly between Group DR and Group D as well as Group PDR and Group NPDR. At the genera level, Pseudomonas, Fusobacterium and Adlercreutzia were increased in Group DR than Group D while Senegalimassilia was decreased (P < 0.05, respectively). At the family level, Pseudomonadaceae, Desulfovibrionaceae and Fusobacteriaceae were significantly increased in Group DR than in Group D (P < 0.05, respectively). Pseudomonas was negatively correlated with NK cell count (r = -0.39, P = 0.03). In addition, the abundance of Pseudomonas, Alloprevotella and Tyzzerella (P < 0.05, respectively) were lower in Group PDR compared to Group NPDR, while genera Eubacterium (P < 0.01), Peptococcus, Desulfovibrio, Acetanaerobacterium and Negativibacillus (P < 0.05, respectively) were higher. Desulfovibrio and Acetanaerobacterium were positively associated with fasting insulin (r = 0.53 and 0.61, respectively, P < 0.05), when Negativibacillus was negatively associated with B cell count (r = −0.67, P < 0.01).
Our research revealed that dysbiosis of gut flora was correlated with DR and its progression among diabetics in the southeast coast of China, probably via several mechanisms including producing influencing permeability of blood vessels, short-chain fatty acids, affecting levels of vascular cell adhesion molecule-1, hypoxia-inducible factor-1, B cell and insulin. Manipulating gut microbiota might be a novel way for prevention of DR, particularly PDR in population above.
This research perspectives are as fellow: (1) Current treatments for DR did not acquire satisfied effect; (2) Animal experiment revealed that reconstruction of gut microbiota could prevent DR; and (3) Does alteration of gut microbiota has connection with DR in human?