To date, reliable tests enabling the identification of celiac disease (CD) patients at a greater risk of developing poly-autoimmune diseases are not yet available. We therefore aimed to identify non-invasive microbial biomarkers, useful to implement diagnosis of poly-autoimmunity. Twenty CD patients with poly-autoimmunity (cases) and 30 matched subjects affected exclusively by CD (controls) were selected. All patients followed a varied gluten-free diet for at least 1 year. Fecal microbiota composition was characterized using bacterial 16S ribosomal RNA gene sequencing. Significant differences in gut microbiota composition between CD patients with and without poly-autoimmune disease were found using the edgeR algorithm. Spearman correlations between gut microbiota and clinical, demographic, and anthropometric data were also examined. A significant reduction of Bacteroides, Ruminococcus, and Veillonella abundances was found in CD patients with poly-autoimmunity compared to the controls. Bifidobacterium was specifically reduced in CD patients with Hashimoto's thyroiditis and its abundance correlated negatively with abdominal circumference values in patients affected exclusively by CD. In addition, the duration of CD correlated with the abundance of Firmicutes (negatively) and Odoribacter (positively), whereas the abundance of Desulfovibrionaceae correlated positively with the duration of poly-autoimmunity. This study provides supportive evidence that specific variations of gut microbial taxa occur in CD patients with poly-autoimmune diseases. These findings open the way to future validation studies on larger cohorts, which might in turn lead to promising diagnostic applications.

迄今为止，尚无法提供可靠的测试方法来鉴定患有更大的自身免疫疾病风险的腹腔疾病（CD）患者。因此，我们旨在鉴定对实施多自身免疫性诊断有用的非侵入性微生物生物标记。选择了20名具有多自身免疫的CD患者（病例）和30名完全受CD影响的匹配受试者（对照）。所有患者均接受多种无麸质饮食至少一年。使用细菌16S核糖体RNA基因测序来表征粪便微生物群组成。使用edgeR算法发现有和没有多自身免疫性疾病的CD患者之间肠道菌群组成存在显着差异。还检查了肠道菌群与临床，人口统计学和人体测量学数据之间的Spearman相关性。拟杆菌，Ruminococcus和 Veillonella 与对照相比，在具有多自身免疫性的CD患者中发现了丰富的蛋白质。 双歧杆菌在患有桥本氏甲状腺炎的CD患者中，其特异性降低了，并且它的丰度与仅受CD影响的患者的腹围值呈负相关。此外，CD的持续时间与肥大菌的丰度（负）相关，并且臭杆菌 （肯定），而 脱硫弧菌科与多自身免疫的持续时间呈正相关。这项研究提供了支持性证据，证明患有多自身免疫性疾病的CD患者存在肠道微生物分类群的特定变异。这些发现为将来在更大的人群中进行验证研究开辟了道路，这反过来可能会导致有希望的诊断应用。