Type 1 diabetes in pregnancy is associated with distinct changes in the composition and function of the gut microbiome
Alexandra J. Roth-Schulze,
Megan A. S. Penno,
Katrina M. Ngui,
Helena Oakey,
Esther Bandala-Sanchez,
Alannah D. Smith,
Theo R. Allnutt,
Rebecca L. Thomson,
Peter J. Vuillermin,
Maria E. Craig,
William D. Rawlinson,
Elizabeth A. Davis,
Mark Harris,
Georgia Soldatos,
Peter G. Colman,
John M. Wentworth,
Aveni Haynes,
Simon C. Barry,
Richard O. Sinnott,
Grant Morahan,
Naiara G. Bediaga,
Gordon K. Smyth,
Anthony T. Papenfuss,
Jennifer J. Couper,
Leonard C. Harrison,
on behalf of the ENDIA Study Group
Affiliations
Alexandra J. Roth-Schulze
Walter and Eliza Hall Institute of Medical Research
Megan A. S. Penno
The University of Adelaide, Robinson Research Institute, Adelaide Medical School, University of Adelaide
Katrina M. Ngui
Walter and Eliza Hall Institute of Medical Research
Helena Oakey
The University of Adelaide, Robinson Research Institute, Adelaide Medical School, University of Adelaide
Esther Bandala-Sanchez
Walter and Eliza Hall Institute of Medical Research
Alannah D. Smith
Walter and Eliza Hall Institute of Medical Research
Theo R. Allnutt
Walter and Eliza Hall Institute of Medical Research
Rebecca L. Thomson
The University of Adelaide, Robinson Research Institute, Adelaide Medical School, University of Adelaide
Peter J. Vuillermin
Faculty of School of Medicine, Deakin University and Child Health Research Unit, Barwon Health
Maria E. Craig
School of Women’s and Children’s Health, Faculty of Medicine, University of New South Wales
William D. Rawlinson
Virology Research Laboratory, Serology and Virology Division, South Eastern Area Laboratory Services Microbiology, Prince of Wales Hospital
Elizabeth A. Davis
Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia
Mark Harris
The University of Queensland Diamantina Institute, Faculty of Medicine, University of Queensland, Translational Research Institute
Georgia Soldatos
Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne and Diabetes and Vascular Medicine Unit, Monash Health
Peter G. Colman
Department of Diabetes and Endocrinology, Royal Melbourne Hospital
John M. Wentworth
Walter and Eliza Hall Institute of Medical Research
Aveni Haynes
Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia
Simon C. Barry
The University of Adelaide, Robinson Research Institute, Adelaide Medical School, University of Adelaide
Richard O. Sinnott
Melbourne eResearch Group, School of Computing and Information Services, University of Melbourne
Grant Morahan
Centre for Diabetes Research, Harry Perkins Institute of Medical Research, The University of Western Australia
Naiara G. Bediaga
Walter and Eliza Hall Institute of Medical Research
Gordon K. Smyth
Walter and Eliza Hall Institute of Medical Research
Anthony T. Papenfuss
Walter and Eliza Hall Institute of Medical Research
Jennifer J. Couper
The University of Adelaide, Robinson Research Institute, Adelaide Medical School, University of Adelaide
Leonard C. Harrison
Walter and Eliza Hall Institute of Medical Research
Abstract Background The gut microbiome changes in response to a range of environmental conditions, life events and disease states. Pregnancy is a natural life event that involves major physiological adaptation yet studies of the microbiome in pregnancy are limited and their findings inconsistent. Pregnancy with type 1 diabetes (T1D) is associated with increased maternal and fetal risks but the gut microbiome in this context has not been characterized. By whole metagenome sequencing (WMS), we defined the taxonomic composition and function of the gut bacterial microbiome across 70 pregnancies, 36 in women with T1D. Results Women with and without T1D exhibited compositional and functional changes in the gut microbiome across pregnancy. Profiles in women with T1D were distinct, with an increase in bacteria that produce lipopolysaccharides and a decrease in those that produce short-chain fatty acids, especially in the third trimester. In addition, women with T1D had elevated concentrations of fecal calprotectin, a marker of intestinal inflammation, and serum intestinal fatty acid-binding protein (I-FABP), a marker of intestinal epithelial damage. Conclusions Women with T1D exhibit a shift towards a more pro-inflammatory gut microbiome during pregnancy, associated with evidence of intestinal inflammation. These changes could contribute to the increased risk of pregnancy complications in women with T1D and are potentially modifiable by dietary means. Video abstract
