AB0123 ENTEROCOCCUS GALLINARUM IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

• Published in: Annals of the rheumatic diseases Vol. 82; no. Suppl 1; pp. 1240 - 1241
• Main Authors: Vega Sevilla, L. F., Alvarez-González, O. E., Riega-Torres, J. C., Rubio Torres, D. C., Skinner Taylor, C. M., Vera Cabrera, L., Cardenas-de la Garza, J. A., Aguilera Valenciano, M. A., Escalante, W., Guerra, H., Galarza-Delgado, D. Á.
• Format: Journal Article
• Language: English
• Published: Kidlington BMJ Publishing Group Ltd and European League Against Rheumatism 01.06.2023; Elsevier B.V; Elsevier Limited
• Subjects: Antibiotics; Arthritis; Autoimmune diseases; Cholangitis; Creatinine; Descriptive studies; Diagnosis; Dysbacteriosis; Hemoglobin; Hemolytic anemia; Hepatitis; Hepatocytes; Immune response; Immune response (cell-mediated); Intestine; Laboratories; Leukocytes; Liver diseases; Lupus; Nephritis; Outcome measures; Patients; Probiotics; Scientific Abstracts; Serositis; Sociodemographics; Systemic lupus erythematosus; Ulcers; Outcome measures; Descriptive studies; Systemic lupus erythematosus
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/annrheumdis-2023-eular.4955

BackgroundSystemic Lupus Erythematosus (SLE) is associated with epithelial defects and disrupted intestinal barrier, risking bacterial translocation and promoting systemic inflammation, known as dysbiosis, which is associated with increased disease activity [1]. Enterococcus gallinarum has been previously linked to gastrointestinal autoimmune diseases, like autoimmune hepatitis and primary sclerosing cholangitis. [2] However, little is known about E. gallinarum prevalence in SLE.ObjectivesTo describe the prevalence of E. gallinarum in SLE stool samples, as well as clinical and laboratory characteristics.MethodsA cross-sectional, descriptive study was conducted at the University Hospital ¨Dr. José Eleuterio González¨, in northern Mexico. We included adult patients who met current criteria for SLE and had recent (<3 months) paraclinical routine tests, including acute phase reactants. Patients with other autoimmune diseases, chronic infections, pregnancy, cancer, abdominal surgery or gastrointestinal bleeding were excluded. Demographic, clinical data, as well as Anti-nuclear antibodies and complement were obtained from records. No participant received antibiotics, probiotics or synbiotics 3 months prior to the study. DNA was extracted with the DNeasy PowerLyzer PowerSoil DNeasy kit, Qiagen (Hilden, Germany) according to the manufacturer’s specifications. E. gallinarum was detected by endpoint polymerase chain reaction essay.ResultsSixty patients were included, where most subjects were women (51, 85%). Mean age was 41.79 (± 16.6) and time of diagnosis 107.03 months (± 95.46). E. gallinarum and Enterococcus spp were found in 7 (11.6%) cases. The most frequent MEX-SLEDAI parameter was arthritis in 34 (56.6%) cases, followed by acute cutaneous lupus in 23 (38.3%). Clinical manifestations and paraclinical findings are shown in Table 1. We found a significant difference in E. gallinarum positive patients in creatinine levels (0.98 vs 0.72, p 0.032), ESR (11.14 vs 19.49, p 0.031) and frequency of serositis (57.14% vs 7.54%, p 0.001). When analyzing ESR by age-adjusted upper limit, significance was lost (p 0.4)ConclusionPrevalence of E. gallinarum in SLE stool samples was 11.7%. Serositis, higher mean creatinine and lower mean ESR was more common in E. gallinarum positive subjects. Further research is needed to better understand E. gallinarum dysbiosis in SLE.References[1] Li Y, Wang HF, Li X, Li HX, Zhang Q, Zhou HW, et al. Disordered intestinal microbes are associated with the activity of Systemic Lupus Erythematosus. Clinical science (London, England: 1979). 2019;133(7):821-38.[2] Nakamoto N, Sasaki N, Aoki R, et al. Gut pathobionts underlie intestinal barrier dysfunction and liver T helper 17 cell immune response in primary sclerosing cholangitis. Nat Microbiol. 2019;4(3):492-503. doi:10.1038/s41564-018-0333-1Table 1.Sociodemographics, clinical and paraclinical features.E. gallinarum Positive n= 7E. gallinarum Negative n= 53pSociodemographic, mean ± SDAge, years37.14 ± 20.642.3 ± 13.80.10Months since diagnosis75.85 ± 59.3112.72 ± 99.50.23Weight, kg58.88 ± 9.1668.19 ± 15.980.06Size, m1.61 ± 0.081.59 ± 0.060.20BMI, Kg/m223.02 ± 4.0226.65 ± 5.890.22Clinical features, n (%)Oral ulcers0 (0.0)5 (9.43)0.42Alopecia2 (28.57)11 (20.75)0.51Arthritis3 (42.85)31 (58.49)0.61Serositis4 (57.14)4 (7.54)0.001Nephritis1 (14.28)8 (15.09)0.95CNS0 (0.0)2 (3.77)0.62Hemolytic anemia0 (0.0)6 (11.32)0.37CKD0 (0.0)1 (1.88)0.72Chronic liver disease0 (0.0)2 (3.77)0.62MEX-SLEDAI, mean ± SD1.71 ± 2.921.83 ± 2.120.89Laboratories, mean ± SDHemoglobin13.87 ± 1.4613.29 ± 1.040.19Leukocytes6.46 ± 1.736.23 ± 2.490.81Lynphocytes5.98 ± 10.165.69 ± 11.240.94Platelets217.71 ± 31.7250.47 ± 79.10.28BUN16.38 ± 8.813.15 ± 5.40.23Creatinine0.98 ± 0.290.72 ± 0.290.03Albumin4.24 ± 0.474.16 ± 0.340.62TGO21.42 ± 6.525.21 ± 10.80.37TGP23.71 ± 22.223.14 ± 15.40.93CRP0.78 ± 1.352.81 ± 7.560.55ESR11.14 ± 7.619.49 ± 13.180.03ANAS2248 ± 2653730 ± 14990.27Anti-Sm13.93 ± 24.1329.11 ± 122.470.83C342.62 ± 36.1954 ± 52.850.48C49.12 ± 9.3210.4 ± 10.950.77AcknowledgementsNo Acknowledgements to declare.Disclosure of InterestsNone Declared.