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Background <p>The gut microbiota in patients with Graves’ orbitopathy (GO) may influence the disease’s progression, but its specific role and function in the progression of GO treatment are not well understood.</p> Methods <p>We performed fecal microbiota sequencing using the 16S rRNA-gene sequencing on patients with GO (<i>n</i> = 48), Graves’ disease (GD, <i>n</i> = 40), and healthy controls (HC, <i>n</i> = 36). Subsequently, fecal samples from patients with GO, GD, and healthy donors were transplanted into antibiotic-treated pseudo-germ-free mice. Finally, the 48 patients with GO were randomly divided into two groups: one group received intravenous glucocorticoids (ivGC) and atorvastatin (<i>n</i> = 24), while the other group received ivGC only (<i>n</i> = 24), to observe the effects of atorvastatin on GO progression and its impact on gut microbiota.</p> Results <p>Patients with GO exhibit a distinct gut microbiota composition, particularly marked by increased levels of <i>Prevotella</i> and <i>Bacteroides</i>, compared to patients with GD and HC. Correlation analysis revealed a direct positive association between <i>Prevotella</i> and thyrotropin receptor antibody levels. Antibiotic-treated pseudo-germ-free mice that received fecal transplants from patients with GO exhibited a slower rate of weight gain, significant impairment of intestinal barrier integrity, and markedly increased levels of serum LBP and inflammatory factors. A combined treatment regimen of ivGCs and atorvastatin significantly reduced ocular clinical symptoms in patients with GO, including clinical activity score, exophthalmos, and intraocular pressure, while also promoting a healthier gut microbiota composition and a reduction in <i>Prevotella</i> levels.</p> Conclusions <p>Gut microbiota imbalance, particularly involving <i>Prevotella</i>, contributes to GO’s development and progression. Atorvastatin may slow GO progression by correcting dysregulated gut microbiota, especially reducing <i>Prevotella</i>.</p> <p><MediaObject ID="MOESM3"> <VideoObject FileRef="MediaObjects/40168_2025_2219_MOESM3_ESM.mp4" VideoID="EKUMEYE87UcK2ohfQ_TgPA"> <Caption Language="En" xml:lang="en"> <CaptionContent> <p>Video Abstract</p> </CaptionContent> </Caption> </VideoObject> </MediaObject></p>

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Modulation of gut microbiota in Graves’ orbitopathy: Prevotella dominance and atorvastatin’s impact

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月29日

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  • Danyu Wang,
  • Yaonan Chen,
  • Junpeng Yang,
  • Yun Zhang,
  • Xinru Deng,
  • Yalei Liu,
  • Yiqi Chen,
  • Xueli Yang,
  • Xiudan Wang,
  • Chenghong Liang,
  • Qinyuan Xie,
  • Yibin Hao,
  • Huijuan Yuan

摘要

Background

The gut microbiota in patients with Graves’ orbitopathy (GO) may influence the disease’s progression, but its specific role and function in the progression of GO treatment are not well understood.

Methods

We performed fecal microbiota sequencing using the 16S rRNA-gene sequencing on patients with GO (n = 48), Graves’ disease (GD, n = 40), and healthy controls (HC, n = 36). Subsequently, fecal samples from patients with GO, GD, and healthy donors were transplanted into antibiotic-treated pseudo-germ-free mice. Finally, the 48 patients with GO were randomly divided into two groups: one group received intravenous glucocorticoids (ivGC) and atorvastatin (n = 24), while the other group received ivGC only (n = 24), to observe the effects of atorvastatin on GO progression and its impact on gut microbiota.

Results

Patients with GO exhibit a distinct gut microbiota composition, particularly marked by increased levels of Prevotella and Bacteroides, compared to patients with GD and HC. Correlation analysis revealed a direct positive association between Prevotella and thyrotropin receptor antibody levels. Antibiotic-treated pseudo-germ-free mice that received fecal transplants from patients with GO exhibited a slower rate of weight gain, significant impairment of intestinal barrier integrity, and markedly increased levels of serum LBP and inflammatory factors. A combined treatment regimen of ivGCs and atorvastatin significantly reduced ocular clinical symptoms in patients with GO, including clinical activity score, exophthalmos, and intraocular pressure, while also promoting a healthier gut microbiota composition and a reduction in Prevotella levels.

Conclusions

Gut microbiota imbalance, particularly involving Prevotella, contributes to GO’s development and progression. Atorvastatin may slow GO progression by correcting dysregulated gut microbiota, especially reducing Prevotella.

Video Abstract