Gut microbiome dysbiosis and metabolic abnormalities were found in NMOSD patients compared to healthy controls, and these differences were markedly alleviated after six months of immunosuppressive treatment.
Key Findings
Results
Alpha-diversity metrics were significantly higher in NMOSD patients than in healthy controls.
21 treatment-naïve NMOSD patients were compared to 21 matched healthy controls (HCs)
Alpha-diversity differences were statistically significant (P < 0.001)
Gut microbial composition was assessed using 16S rRNA gene sequencing
The study used a longitudinal cohort design
Results
NMOSD patients showed increased abundances of Streptococcus and Ruminococcus at the genus level compared to healthy controls.
Linear discriminant analysis scores were greater than 4 for these genera
Differences were statistically significant (P < 0.001)
These findings were identified through 16S rRNA gene sequencing of fecal samples
Both genera were enriched in NMOSD patients relative to HCs
Results
NMOSD patients showed decreased abundances of Faecalibacterium, Ralstonia, and Pseudomonas at the genus level compared to healthy controls.
Linear discriminant analysis scores were greater than 4 for all three genera
Differences were statistically significant (P < 0.001) for all genera
These genera were depleted in NMOSD patients relative to HCs
Findings were based on 16S rRNA gene sequencing
Results
Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt) analysis identified 19 differentially abundant metabolites and 44 altered metabolic pathways in NMOSD patients compared to healthy controls.
Metabolomic profiling was performed using ultra-high-performance liquid chromatography-mass spectrometry (UHPLC-MS)
19 metabolites were differentially abundant between NMOSD patients and HCs
44 metabolic pathways were altered in NMOSD patients compared to HCs
Both microbial composition and metabolomic profiles were distinct between NMOSD patients and HCs
Results
Immunosuppressive treatment for over six months shifted gut microbiota composition and metabolite profiles of NMOSD patients closer to those of healthy controls.
Fecal samples from NMOSD patients were collected before and reassessed after immunosuppressant treatment
The treatment duration assessed was over six months
Gut microbiome dysbiosis and metabolic abnormalities were described as 'markedly alleviated' after six months of immunosuppressive treatment
The longitudinal design allowed within-patient comparison of pre- and post-treatment microbiota
Du Q, Wang X, Shi Z, Chen H, Zhang Y, Wang R, et al.. (2026). Dysbiosis of intestinal microbiota in patients with neuromyelitis optica spectrum disorders.. Frontiers in immunology. https://doi.org/10.3389/fimmu.2026.1747643