Anxiety Disorders and Gut Dysbiosis in Primary Sjögren’s Syndrome-Mediated Dry Eye Patients

Abstract

Yiting Zhang, Meiqi Gan, Yuqin He, Tingting Liu, Mei Xu The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing Municipality Division, National Clinical Research Center for Ocular Diseases, Chongqing, People’s Republic of ChinaCorrespondence: Mei Xu, The First Affiliated Hospital of Chongqing Medical University, Youyi Road 1, Chongqing, 400016, People’s Republic of China, Email [email protected]: Primary Sjögren’s syndrome (pSS), a disease that is associated with a high prevalence of psychological disorders, has become increasingly important. Interactions between the gut microbiota and ocular conditions have been identified in pSS. As mental intervention is frequently needed, this study aims to investigate the relationship between anxiety disorders and the gut microbiome in patients with pSS-mediated dry eye.Methods: Demographics and self-administered questionnaires were obtained. Faecal samples were evaluated using 16S ribosomal RNA gene sequencing.Results: The Hospital Anxiety and Depression Scale (HADS-A) cut-off point of ≥ 8 points showed a sensitivity and specificity of 76.5% and 80.0%, respectively. In all participants, we found that the prevalence of anxiety disorder was 30.4%. Dry eye discomfort could promote an anxious state, and conversely, anxiety could threaten tear film and increase the risk of pSS activity. There was a certain correlation between anxiety disorder and gut dysbiosis. Prevotella was associated with dry eye severity (p < 0.001). Bacteroidetes (p =0.046) and Odoribacter (p =0.001) were correlated with pSS activity.Conclusion: There is a bidirectional relationship between anxiety disorder and the gut microbiota in pSS-mediated dry eye. Alterations in certain classes of gut microbiota are associated with pSS activity and dry eye severity. Main gut microbiota alterations that have a facilitating impact on anxiety are emerging in pSS-mediated dry eye. Future studies are needed to explore specific therapeutic targets for improving mental health in pSS-mediated dry eye by microbiota intervention.Keywords: primary Sjögren’s syndrome, dry eye, anxiety, gut microbiota

Keywords

• primary sjögren’s syndrome
• dry eye
• anxiety
• gut microbiota