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

Abstract

Purpose

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

Ethics Approval and Informed Consent

The study was approved by the ethics committee of the First Affiliated Hospital of Chongqing Medical University and adhered to the ethical standards of Declaration of Helsinki and its later amendments or comparable ethical standards. All the patients completed written informed consent. All the participating patients were fully informed and participated in the study voluntarily. We have obtained informed consents from all the study participants prior to study commencement.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

The study was funded by the National Natural Science Foundation of China (81900887), and Basic science and frontier technology research in Chongqing (cstc2017jcyjAX0447).