Resumen de Caracterización de microbiota fecal en pacientes con síndrome de sjogren primario y su relación con la permeabilidad intestinal e inflamación
1. Introducción o motivación de la tesis El síndrome de Sjögren (SS) es una enfermedad de tipo autoinmune con importante afectación ocular. Su etiología es aún desconocida con un número de factores elevados como posibles generadores de la enfermedad. El cambio en la microbiota intestinal ha sido reportado como un factor diferencial entre los sujetos sanos y los sujetos con SS. Diferencias en la microbiota intestinal han sido reportantadas en otras patologías sistémicas autoinmunes.
Para no tener factores de confusión entre otras patologías sistémicas autoinmunes se ha realizado un estudio en pacientes estrictamente seleccionados y con ausencia de otras alteraciones inmunitarias, siendo seleccionados sólo los pacientes con síndrome de Sjögren primario (SSP).
Los objetivos de esta tesis doctoral han sido la caracterización de microbiota fecal en pacientes con SSP comparados con pacientes sanos, la determinación de parámetros inflamatorios en plasma de pacientes con SSP comparados con pacientes sanos y su relación con microbiota fecal, así como la determinación de permeabilidad intestinal a través de zonulina plasmática.
2. Contenido de la investigación En esta tesis doctoral se ha realizado un estudio de pacientes con SSP para poder establecer si los cambios en la microbiota intestinal son asociados a la presencia de esta enfermedad de forma aislada, o bien si en el SSP no existen diferencias con los sujetos sanos. De este modo podríamos centrar investigaciones posteriores en otras patologías autoinmunes como la artirtis reumatoide (AR) y el lupus eritematosis sistémico (LES), entre otras. Algunos autores han estudiado patologías autoinmunes encontrando diferencias en la microbiota intestinal lo que nos ha llevado a profundizar en el estudio del SSP como entidad aislada sin otras enfermedades autoinunes asociadas que nos lleven a posibles confusiones.
Se han estudiado parámetros de inflamación y de permeabilidad intestinal para intentar establecer relaciones entre estos parámetros y los cambios de la microbiota intestinal, así como se ha intentado establecer o aportar información sobre la etiopatogenia de la enfermedad.
3. Conclusión Los resultados obtenidos muestran que la microbiota intestinal de los pacientes con SSP difieren tanto a nivel taxonómico como a nivel funcional con respecto a controles sanos. El perfil de microbiota intestinal de nuestros pacientes con SSP presentó una menor diversidad y riqueza siendo el filo Bacteroidetes el grupo más representado Se ha encontrado un aumento de la producción de citoquinas proinflamatorias y la disminución de la liberación de citoquinas antiinflamatorias (IL-10). Se necesitan más estudios para comprender mejor la realidad del impacto de la disbiosis en el curso del SSP y para concebir estrategias preventivas o terapéuticas para contrarrestar la inflamación impulsada por el microbioma.
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