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Observational Study
. 2017 Dec 6;12(12):e0188475.
doi: 10.1371/journal.pone.0188475. eCollection 2017.

Distinct fecal and oral microbiota composition in human type 1 diabetes, an observational study

Pieter F de Groot  1 , Clara Belzer  2 , Ömrüm Aydin  1 , Evgeni Levin  1 , Johannes H Levels  1 , Steven Aalvink  2 , Fransje Boot  1 , Frits Holleman  1 , Daniël H van Raalte  3   4 , Torsten P Scheithauer  1   3   4 , Suat Simsek  5 , Frank G Schaap  6   7   8 , Steven W M Olde Damink  6 , Bart O Roep  9   10 , Joost B Hoekstra  1 , Willem M de Vos  2   11 , Max Nieuwdorp  1   3   4   12
Affiliations
Observational Study

Distinct fecal and oral microbiota composition in human type 1 diabetes, an observational study

Pieter F de Groot et al. PLoS One. .

Abstract

Objective: Environmental factors driving the development of type 1 diabetes (T1D) are still largely unknown. Both animal and human studies have shown an association between altered fecal microbiota composition, impaired production of short-chain fatty acids (SCFA) and T1D onset. However, observational evidence on SCFA and fecal and oral microbiota in adults with longstanding T1D vs healthy controls (HC) is lacking.

Research design and methods: We included 53 T1D patients without complications or medication and 50 HC matched for age, sex and BMI. Oral and fecal microbiota, fecal and plasma SCFA levels, markers of intestinal inflammation (fecal IgA and calprotectin) and markers of low-grade systemic inflammation were measured.

Results: Oral microbiota were markedly different in T1D (eg abundance of Streptococci) compared to HC. Fecal analysis showed decreased butyrate producing species in T1D and less butyryl-CoA transferase genes. Also, plasma levels of acetate and propionate were lower in T1D, with similar fecal SCFA. Finally, fecal strains Christensenella and Subdoligranulum correlated with glycemic control, inflammatory parameters and SCFA.

Conclusions: We conclude that T1D patients harbor a different amount of intestinal SCFA (butyrate) producers and different plasma acetate and propionate levels. Future research should disentangle cause and effect and whether supplementation of SCFA-producing bacteria or SCFA alone can have disease-modifying effects in T1D.

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Conflict of interest statement

Competing Interests: WM de Vos is on the Scientific Advisory Board of Caelus Health, and M Nieuwdorp is on the Scientific Advisory Board of Caelus Health. The other authors have nothing to disclose.

Figures

Fig 1
Fig 1. Plasma SCFA and dietary fiber intake.
The figure shows that (A) despite higher fiber intake, we (B) found decreased plasma levels of acetate and (C) propionate and (D) similar levels of plasma butyrate in controls vs T1D subjects.
Fig 2
Fig 2. Fecal microbiota composition.
Differences in (A) fecal and (B) oral microbiota composition as depicted by a biplot of Redundancy Analysis (RDA axis 1 vs. axis 2) constrained by T1D or controls.
Fig 3
Fig 3. Most discriminating fecal species.
Relative abundances of most discriminating fecal microbiota resulting from our elastic net analysis for (A) T1D patients and (B) healthy controls (B).
Fig 4
Fig 4. Most discriminating oral species.
Relative abundances of most discriminating oral microbiota resulting from our elastic net analysis for (A) T1D patients and (B) healthy controls (B). Please note that the y-axes differ between figures and that Streptococcus abundance was relatively very large (0.53 in T1D and 0.43 in healthy controls) and did not fit in the figure.
See this image and copyright information in PMC

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