Effect of Fufang Huangqi Decoction on the Gut Microbiota in Patients With Class I or II Myasthenia Gravis

Abstract

ObjectiveTo investigate the effect of Fufang Huangqi Decoction on the gut microbiota in patients with class I or II myasthenia gravis (MG) and to explore the correlation between gut microbiota and MG (registration number, ChiCTR2100048367; registration website, http://www.chictr.org.cn/listbycreater.aspx; NCBI: SRP338707).MethodsIn this study, microbial community composition and diversity analyses were carried out on fecal specimens from MG patients who did not take Fufang Huangqi Decoction (control group, n = 8) and those who took Fufang Huangqi Decoction and achieved remarkable alleviation of symptoms (medication group, n = 8). The abundance, diversity within and between habitats, taxonomic differences and corresponding discrimination markers of gut microbiota in the control group and medicated group were assessed.ResultsCompared with the control group, the medicated group showed a significantly decreased abundance of Bacteroidetes (P < 0.05) and significantly increased abundance of Actinobacteria at the phylum level, a significantly decreased abundance of Bacteroidaceae (P < 0.05) and significantly increased abundance of Bifidobacteriaceae at the family level and a significantly decreased abundance of Blautia and Bacteroides (P < 0.05) and significantly increased abundance of Bifidobacterium, Lactobacillus and Roseburia at the genus level. Compared to the control group, the medicated group had decreased abundance, diversity, and genetic diversity of the communities and increased coverage, but the differences were not significant (P > 0.05); the markers that differed significantly between communities at the genus level and influenced the differences between groups were Blautia, Bacteroides, Bifidobacterium and Lactobacillus.ConclusionsMG patients have obvious gut microbiota-associated metabolic disorders. Fufang Huangqi Decoction regulates the gut microbiota in patients with class I or II MG by reducing the abundance of Blautia and Bacteroides and increasing the abundance of Bifidobacterium and Lactobacillus. The correlation between gut microbiota and MG may be related to cell-mediated immunity.

The Role of Human Microbiota in Myasthenia Gravis: A Narrative Review

“…Chen et al showed that the administration of Fufang Huangqi Decoction in eight MG patients (Myasthenia Gravis Foundation of America classes I and II) reduced the abundance of Blautia and Bacteroides and increased the presence of Bifidobacterium and Lactobacillus. These changes alleviated the symptoms of MG patients [ 71 ]. Although TCM originally appeared as a mythological doctrine, recently it has growing acceptance in Europe and in other Western countries [ 86 ].…”

Gut microbiota in muscular atrophy development, progression, and treatment: New therapeutic targets and opportunities

“… 23 The microbiota of MG patients who were administered fufang huangqi decoction and achieved remarkable alleviation of symptoms underwent alteration, with the abundance of Blautia and Bacteroides decreasing and Bifidobacterium , Lactobacillus , and Roseburia increasing. 24 The progression of the disease was benefitted by the administration of two probiotic strains of Bifidobacterium and Lactobacillus in the Lewis rat model of myasthenia gravis (EAMG). Probiotic interactions with Peyer’s patches and greater α and β diversity in probiotic-treated EAMG were observed.…”

“… 28 Only one clinical intervention has demonstrated efficacy compared with no treatment; patients with MG administered fufang guangqi decoction achieve significant symptom relief. 24 Patients with MG who are medicated have different microbial communities than control patients; they tend to have lower levels of Blautia and Bacteroides and higher levels of Bifidobacterium and Lactobacillus at the genus level. 24 …”

Oral Microbiota Profile in a Group of Anti-AChR Antibody–Positive Myasthenia Gravis Patients

“…Myasthenia gravis (MG) is an autoimmune disease caused by pathogenic autoantibodies targeting the neuromuscular junction (NMJ); these include anti-acetylcholinereceptor (AchR), anti–muscle-specific tyrosine kinase (MuSK), and anti–low-density lipoprotein receptorrelated protein 4 (LRP4) antibodies. Anti-AChR antibodyis detected with routine assays in 70–80% of all patients with MG. Based on the location of the affected muscles, MG is classified as ocular or generalized ( 3 ). The pathogenesis of MG is complex and involves an imbalance of gut microbiota ( 4 , 5 ).…”