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  • Reduced salivary secretion contributes more to changes in the oral microbiome of patients with primary Sjögren’s syndrome than underlying disease

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Reduced salivary secretion contributes more to changes in the oral microbiome of patients with primary Sjögren’s syndrome than underlying disease
  1. Taco A van der Meulen1,
  2. Hermie J M Harmsen2,
  3. Hendrika Bootsma3,
  4. Silvia C Liefers1,
  5. Arnau Vich Vila4,5,
  6. Alexandra Zhernakova5,
  7. Rinse K Weersma4,
  8. Fred K L Spijkervet1,
  9. Frans G M Kroese3,
  10. Arjan Vissink1
  1. 1 Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
  2. 2 Department of Medical Microbiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
  3. 3 Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
  4. 4 Department of Gastroenterology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
  5. 5 Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, Groningen, Netherlands
  1. Correspondence to Taco A van der Meulen, Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen 9713 GZ, The Netherlands; t.a.van.der.meulen{at}umcg.nl

http://dx.doi.org/10.1136/annrheumdis-2018-213026

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    The oral microbiome of patients with primary Sjögren’s syndrome (pSS) differs from that of healthy individuals.1–3 Whether these changes are the consequence of reduced salivary secretion or specific for pSS is yet unknown. Therefore, the aim of our study was to assess whether patients with pSS have a specific oral microbiome compared with symptom controls (patients without SS, indicated as non-SS patients) and healthy controls (HCs).

    To capture the overall bacterial composition in the mouth, we collected oral washings instead of buccal swabs from 121 consecutive patients referred for a diagnostic pSS workup and 14 volunteers without oral or ocular dryness (HCs). Patients fulfilling the 2016 American College of Rheumatology/European League Against Rheumatism classification criteria were classified as pSS (n=36) and patients not fulfilling the criteria as non-SS (n=85) (table 1).4

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    Table 1

    Patient characteristics*

    Bacterial composition was assessed with 16S rRNA gene sequencing of the V4 region. Reads were processed and diversity was analysed with QIIME V.1.9.1.5 All samples were equated to 8000 reads/sample. Comparative statistics were performed in R V.3.4.2.6 For details see online Supplementary text.

    Supplementary file 1

    [SP1.docx]

    Alpha diversity, that is, the number of bacterial taxa and proportion in which each taxon is represented per sample was measured by the number of observed operational taxonomic units and Shannon index. Alpha diversity was similar between pSS, non-SS and HCs, indicating that oral washings of …

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    Footnotes

    • Handling editor Josef S Smolen

    • Contributors TAvdM designed the study, performed the analyses and wrote the manuscript. HJMH helped in the design and interpretation of analyses and critically reviewed the manuscript. HB was involved in collecting the clinical information of the patients and reviewed the manuscript. SL helped in designing and performing the laboratory workflow and reviewed the manuscript. AVV helped with statistical design and analysis and reviewed the manuscript critically. AZ, RKW and FKLS were involved in the design, data interpretation and review of the manuscript. FGMK and AV contributed to the conception and design of the study, helped with the interpretation of results and critically reviewed the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval The medical ethical committee of the University Medical Center Groningen.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement 16S rRNA sequencing data is available upon request from the corresponding author.