Introduction
Previous studies have proposed a possible gut–skin axis, and linked gut microbiota to psoriasis risks. However, there is heterogeneity in existing evidence. Observational research is prone to bias, and it is hard to determine causality. Therefore, this study aims to evaluate possible causal associations between gut microbiota (GM) and psoriasis.
Methods
With published large-scale GWAS (genome-wide association study) summary datasets, two-sample Mendelian randomization (MR) was performed to sort out possible causal roles of GM in psoriasis and arthropathic psoriasis (PsA). The inverse variance weighted (IVW) method was taken as the primary evaluation of causal association. As complements to the IVW method, we also applied MR-Egger, weighted median. Sensitivity analyses were conducted using Cochrane’s
Q
test, MR-Egger intercept test, MR-PRESSO (Mendelian Randomization Pleiotropy RESidual Sum and Outlier) global test, and leave-one-out analysis.
Results
By primary IVW analysis, we identified nominal protective roles of Bacteroidetes (odds ratio, OR 0.81,
P
= 0.033) and
Prevotella9
(OR 0.87,
P
= 0.045) in psoriasis risks. Bacteroidia (OR 0.65,
P
= 0.03), Bacteroidales (OR 0.65,
P
= 0.03), and
Ruminococcaceae
UCG002 (OR 0.81,
P
= 0.038) are nominally associated with lower risks for PsA. On the other hand, Pasteurellales (OR 1.22,
P
= 0.033), Pasteurellaceae (OR 1.22,
P
= 0.033),
Blautia
(OR 1.46,
P
= 0.014),
Methanobrevibacter
(OR 1.27,
P
= 0.026), and
Eubacterium fissicatena
group (OR 1.21,
P
= 0.028) are nominal risk factors for PsA. Additionally,
E. fissicatena
group is a possible risk factor for psoriasis (OR 1.22,
P
= 0.00018). After false discovery rate (FDR) correction,
E. fissicatena
group remains a risk factor for psoriasis (
P
FDR
= 0.03798).
Conclusion
We comprehensively evaluated possible causal associations of GM with psoriasis and arthropathic psoriasis, and identified several nominal associations.
E. fissicatena
group remains a risk factor for psoriasis after FDR correction. Our results offer promising therapeutic targets for psoriasis clinical management.
Supplementary Information
The online version contains supplementary material available at 10.1007/s13555-023-01007-w.