Clinical Trials Targeting the Gut-microbiome to Effect Ocular Health: a Systematic Review

Overview

Journal Eye (Lond)

Specialty Ophthalmology

Date 2023 Mar 15

PMID 36918627

Authors

Matthew W Russell

Justin C Muste

Blanche L Kuo

Anna K Wu

Rishi P Singh

Affiliations

Soon will be listed here.

Abstract

Clinical trials targeting the gut microbiome to mitigate ocular disease are now on the horizon. A review of clinical data thus far is essential to determine future directions in this novel promising field. This review examines recent clinical trials that support the plausibility of a gut-eye axis, and may form the basis of novel clinical interventions. PubMed was queried for English language clinical studies examining the relationships between gut microbiota and ocular pathology. 25 studies were extracted from 828 candidate publications, which suggest that gut imbalance is associated with ocular pathology. Of these, only four interventional studies exist which suggest probiotic supplementation or fecal microbiota transplant can reduce symptoms of chalazion or uveitis. The gut-eye axis appears to hold clinical relevance, but current data is limited in sample size and design. Further investigation via longitudinal clinical trials may be warranted.

Citing Articles

Gut Microbiota Profiles in Myopes and Nonmyopes.

Omar W, Singh G, McBain A, Cruickshank F, Radhakrishnan H Invest Ophthalmol Vis Sci. 2024; 65(5):2.

PMID: 38691091 PMC: 11077909. DOI: 10.1167/iovs.65.5.2.

Ocular Surface Microbiota in Naïve Keratoconus: A Multicenter Validation Study.

Rocha-de-Lossada C, Mazzotta C, Gabrielli F, Papa F, Gomez-Huertas C, Garcia-Lopez C J Clin Med. 2023; 12(19).

PMID: 37834997 PMC: 10573816. DOI: 10.3390/jcm12196354.

Targeting the Gut-Eye Axis: An Emerging Strategy to Face Ocular Diseases.

Campagnoli L, Varesi A, Barbieri A, Marchesi N, Pascale A Int J Mol Sci. 2023; 24(17).

PMID: 37686143 PMC: 10488056. DOI: 10.3390/ijms241713338.

References

Holvoet T, Joossens M, Vazquez-Castellanos J, Christiaens E, Heyerick L, Boelens J . Fecal Microbiota Transplantation Reduces Symptoms in Some Patients With Irritable Bowel Syndrome With Predominant Abdominal Bloating: Short- and Long-term Results From a Placebo-Controlled Randomized Trial. Gastroenterology. 2020; 160(1):145-157.e8. DOI: 10.1053/j.gastro.2020.07.013. View

Nakamura Y, Metea C, Karstens L, Asquith M, Gruner H, Moscibrocki C . Gut Microbial Alterations Associated With Protection From Autoimmune Uveitis. Invest Ophthalmol Vis Sci. 2016; 57(8):3747-58. PMC: 4960998. DOI: 10.1167/iovs.16-19733. View

Burton J, Drummond B, Chilcott C, Tagg J, Thomson W, Hale J . Influence of the probiotic Streptococcus salivarius strain M18 on indices of dental health in children: a randomized double-blind, placebo-controlled trial. J Med Microbiol. 2013; 62(Pt 6):875-884. DOI: 10.1099/jmm.0.056663-0. View

Das T, Jayasudha R, Chakravarthy S, Prashanthi G, Bhargava A, Tyagi M . Alterations in the gut bacterial microbiome in people with type 2 diabetes mellitus and diabetic retinopathy. Sci Rep. 2021; 11(1):2738. PMC: 7854632. DOI: 10.1038/s41598-021-82538-0. View

Rowan S, Jiang S, Korem T, Szymanski J, Chang M, Szelog J . Involvement of a gut-retina axis in protection against dietary glycemia-induced age-related macular degeneration. Proc Natl Acad Sci U S A. 2017; 114(22):E4472-E4481. PMC: 5465926. DOI: 10.1073/pnas.1702302114. View

Rokkas T, Gisbert J, Gasbarrini A, Hold G, Tilg H, Malfertheiner P . A network meta-analysis of randomized controlled trials exploring the role of fecal microbiota transplantation in recurrent infection. United European Gastroenterol J. 2019; 7(8):1051-1063. PMC: 6794697. DOI: 10.1177/2050640619854587. View

Jayasudha R, Chakravarthy S, Prashanthi G, Sharma S, Garg P, Murthy S . Alterations in gut bacterial and fungal microbiomes are associated with bacterial Keratitis, an inflammatory disease of the human eye. J Biosci. 2018; 43(5):835-856. View

Chakravarthy S, Jayasudha R, Prashanthi G, Ali M, Sharma S, Tyagi M . Dysbiosis in the Gut Bacterial Microbiome of Patients with Uveitis, an Inflammatory Disease of the Eye. Indian J Microbiol. 2018; 58(4):457-469. PMC: 6141402. DOI: 10.1007/s12088-018-0746-9. View

Kothavade R, Kura M, Valand A, Panthaki M . Candida tropicalis: its prevalence, pathogenicity and increasing resistance to fluconazole. J Med Microbiol. 2010; 59(Pt 8):873-880. DOI: 10.1099/jmm.0.013227-0. View

10.

Napolitano P, Filippelli M, Davinelli S, Bartollino S, DellOmo R, Costagliola C . Influence of gut microbiota on eye diseases: an overview. Ann Med. 2021; 53(1):750-761. PMC: 8168766. DOI: 10.1080/07853890.2021.1925150. View

11.

Radjabzadeh D, Uitterlinden A, Kraaij R . Microbiome measurement: Possibilities and pitfalls. Best Pract Res Clin Gastroenterol. 2018; 31(6):619-623. DOI: 10.1016/j.bpg.2017.10.008. View

12.

Ye P, Zhang X, Xu Y, Xu J, Song X, Yao K . Alterations of the Gut Microbiome and Metabolome in Patients With Proliferative Diabetic Retinopathy. Front Microbiol. 2021; 12:667632. PMC: 8457552. DOI: 10.3389/fmicb.2021.667632. View

13.

Bolte L, Vich Vila A, Imhann F, Collij V, Gacesa R, Peters V . Long-term dietary patterns are associated with pro-inflammatory and anti-inflammatory features of the gut microbiome. Gut. 2021; 70(7):1287-1298. PMC: 8223641. DOI: 10.1136/gutjnl-2020-322670. View

14.

Huang X, Ye Z, Cao Q, Su G, Wang Q, Deng J . Gut Microbiota Composition and Fecal Metabolic Phenotype in Patients With Acute Anterior Uveitis. Invest Ophthalmol Vis Sci. 2018; 59(3):1523-1531. DOI: 10.1167/iovs.17-22677. View

15.

Moubayed N, Bhat R, Al Farraj D, Dihani N, El Ansary A, Fahmy R . Screening and identification of gut anaerobes (Bacteroidetes) from human diabetic stool samples with and without retinopathy in comparison to control subjects. Microb Pathog. 2019; 129:88-92. DOI: 10.1016/j.micpath.2019.01.025. View

16.

Zysset-Burri D, Keller I, Berger L, Neyer P, Steuer C, Wolf S . Retinal artery occlusion is associated with compositional and functional shifts in the gut microbiome and altered trimethylamine-N-oxide levels. Sci Rep. 2019; 9(1):15303. PMC: 6814871. DOI: 10.1038/s41598-019-51698-5. View

17.

Khan R, Sharma A, Ravikumar R, Parekh A, Srinivasan R, George R . Association Between Gut Microbial Abundance and Sight-Threatening Diabetic Retinopathy. Invest Ophthalmol Vis Sci. 2021; 62(7):19. PMC: 8212427. DOI: 10.1167/iovs.62.7.19. View

18.

Wastyk H, Fragiadakis G, Perelman D, Dahan D, Merrill B, Yu F . Gut-microbiota-targeted diets modulate human immune status. Cell. 2021; 184(16):4137-4153.e14. PMC: 9020749. DOI: 10.1016/j.cell.2021.06.019. View

19.

Jayasudha R, Chakravarthy S, Prashanthi G, Sharma S, Tyagi M, Shivaji S . Implicating Dysbiosis of the Gut Fungal Microbiome in Uveitis, an Inflammatory Disease of the Eye. Invest Ophthalmol Vis Sci. 2019; 60(5):1384-1393. DOI: 10.1167/iovs.18-26426. View

20.

Hakansson A, Molin G . Gut microbiota and inflammation. Nutrients. 2012; 3(6):637-82. PMC: 3257638. DOI: 10.3390/nu3060637. View