Evaluation of intestinal dysmicrobism in patients with systemic scleroderma: imbalances between pathogenic flora and commensal bacteria
DOI:
https://doi.org/10.52556/2587-3873.2025.2(104).15Keywords:
systemic scleroderma, intestinal dysmicrobism, pathogenic floraAbstract
Systemic scleroderma (SS) is a rare autoimmune disease characterized by cutaneous and visceral fibrosis, vascular and immunological involvement. In recent years, the intestinal dysmicrobism has been recognized as an important factor in regulating the immune response and in the development of chronic inflammation. Intestinal dysmicrobism defined as the imbalance between commensal and pathogenic bacteria, has been associated with the severity and activity of the disease in SS. To evaluate the intestinal microbiota profile in patients with systemic scleroderma and to analyze the relationship between the microbiota imbalance and gastrointestinal clinical manifestations. The study included 74 patients with SS (70 women, 4 men, mean age 57.74 ± 1.05 years), hospitalized in 2024-2025 in rheumatology departments in the Republic of Moldova. The limited form was present in 64.86%, and the diffuse form in 35.14%. The status of the intestinal microbiota was assessed bacteriologically from intestinal content samples. Patients with SS showed a significant reduction in commensal bacteria (especially Lactobacillus species, Bifidobacterium spp.) and an increase in opportunistic and pro-inflammatory species (Escherichia coli, Candida spp., Klebsilla pneumoniae, Pseudomonas aeruginosa, Proteus mirabilis, Citrobacter freundi, Enterobacter cloacae). Dysmicrobism was identified in 85.14% of patients and correlated with the severity of digestive symptoms, especially dysphagia and heartburn. Intestinal dysmicrobism is common (85.14%) in SS and reflects an imbalance between protective and pathogenic flora. These changes may contribute to systemic inflammation and digestive dysfunction, highlighting the importance of evaluating the microbiota as a diagnostic and therapeutic tool.
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