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. 2025 Feb 16;26(4):1689.
doi: 10.3390/ijms26041689.

Different Gut Microbiome Profiles in Patients with Transthyretin Amyloidosis with and Without Cardiac Involvement

João Henrique Rissato  1 , Natalia de Melo Pereira  1 , Cristhian Espinoza Romero  1 , Georgina Del Cisne Jadán Luzuriaga  1 , Bruno Vaz Kerges Bueno  1 , Caio Rebouças Fonseca Cafezeiro  1 , Aristóteles Comte de Alencar Neto  1 , Thaís Sousa Borges  1 , Suenia Freitas Carvalhal  1 , Félix Jose Alvarez Ramires  1 , Luciano Nastari  1 , Charles Mady  1 , Fábio Fernandes  1
Affiliations

Different Gut Microbiome Profiles in Patients with Transthyretin Amyloidosis with and Without Cardiac Involvement

João Henrique Rissato et al. Int J Mol Sci. .

Abstract

Transthyretin amyloidosis (ATTR amyloidosis) is characterized by the buildup of amyloid protein in organs like the gut and the heart. As a result, hypoperfusion, edema, and dysautonomia cause an imbalance in the gut microbiome. We aimed to identify the gut microbiome composition in ATTR amyloidosis patients with and without heart involvement, as well in controls. Sixty participants were divided into three groups: 20 with ATTR amyloidosis and heart involvement (G1), 19 with ATTR amyloidosis but no heart disease (G2), and 21 controls (G3). The microbiome profiles were obtained through 16S rRNA gene sequencing. Additional evaluations included a clinical questionnaire, echocardiogram, six-minute walk tests, troponin, BNP, and genotype analysis. Compared to G3, G1, and G2 groups had different levels of Streptococcus, Lachnospiraceae, and Sellimonas, while the controls showed a higher relative abundance of Methanosphaera. Streptococcus was linked to higher troponin levels. Lachnospiraceae was associated with lower BNP levels and smaller left atrium volumes. Sellimonas was associated with a higher intestinal symptom score, while Methanosphaera with a lower symptom score. ATTR amyloidosis patients have a different intestinal microbiome profile compared to the control group. There were correlations with genotype, gastrointestinal symptoms, heart failure biomarkers, echocardiographic parameters, and the six-minute walk test.

Keywords: amyloidosis; cardiomyopathies; gastrointestinal microbiome; gastrointestinal tract; heart failure.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The interface between heart failure and the intestinal microbiome.
Figure 2
Figure 2
(A) Comparison of groups based on alpha diversity. (B) Group comparison based on beta diversity using the Bray-Curtis index. Each dot represents a participant.
Figure 3
Figure 3
Relative abundance of bacterial genera in the three groups of patients studied (heatmap).
Figure 4
Figure 4
(A,B) Correlation between general gastrointestinal symptoms and relative abundance of bacterial taxa. (C) Correlation between troponin I levels and relative abundance of bacterial taxa. (D) Correlation between BNP levels and relative abundance of bacterial taxa.
Figure 4
Figure 4
(A,B) Correlation between general gastrointestinal symptoms and relative abundance of bacterial taxa. (C) Correlation between troponin I levels and relative abundance of bacterial taxa. (D) Correlation between BNP levels and relative abundance of bacterial taxa.
Figure 4
Figure 4
(A,B) Correlation between general gastrointestinal symptoms and relative abundance of bacterial taxa. (C) Correlation between troponin I levels and relative abundance of bacterial taxa. (D) Correlation between BNP levels and relative abundance of bacterial taxa.
Figure 5
Figure 5
(A) Correlation between left atrium volume and relative abundance of bacterial taxa. (B) Correlation between cardiac mass index and relative abundance of bacterial taxa. (C) Correlation between patient genotype and relative abundance of bacterial genera. (D) Correlation between 6MWT and relative abundance of bacterial genera.
Figure 5
Figure 5
(A) Correlation between left atrium volume and relative abundance of bacterial taxa. (B) Correlation between cardiac mass index and relative abundance of bacterial taxa. (C) Correlation between patient genotype and relative abundance of bacterial genera. (D) Correlation between 6MWT and relative abundance of bacterial genera.
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References

    1. Jiang X., Buxbaum J.N., Kelly J.W. The V122I cardiomyopathy variant of transthyretin increases the velocity of rate-limiting tetramer dissociation, resulting in accelerated amyloidosis. Proc. Natl. Acad. Sci. USA. 2001;98:14943–14948. doi: 10.1073/pnas.261419998. - DOI - PMC - PubMed
    1. Ruberg F.L., Berk J.L. Transthyretin (TTR) Cardiac Amyloidosis. Circulation. 2012;126:1286–1300. doi: 10.1161/CIRCULATIONAHA.111.078915. - DOI - PMC - PubMed
    1. Gallo A., Macerola N., Favuzzi A.M., Nicolazzi M.A., Gasbarrini A., Montalto M. The Gut in Heart Failure: Current Knowledge and Novel Frontiers. Med. Princ. Pract. 2022;31:203–214. doi: 10.1159/000522284. - DOI - PMC - PubMed
    1. Qin J., Li R., Raes J., Arumugam M., Burgdorf K.S., Manichanh C., Nielsen T., Pons N., Levenez F., Yamada T., et al. A human gut microbial gene catalogue established by metagenomic sequencing. Nature. 2010;464:59–65. doi: 10.1038/nature08821. - DOI - PMC - PubMed
    1. Shen J., Obin M.S., Zhao L. The gut microbiota, obesity and insulin resistance. Mol. Asp. Med. 2013;34:39–58. doi: 10.1016/j.mam.2012.11.001. - DOI - PubMed

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