Gut Microbiota in Graves’ Disease and Graves’ Orbitopathy: Distinct Microbial Signatures and Implications Original paper
Researched by:
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Giorgos Aristotelous
ID
Giorgos Aristotelous
Read MoreGiorgos — BSc, MSc. Giorgos is an exercise scientist whose training and professional practice sit at the intersection of human performance, clinical health, and emerging microbiome science. He holds a BSc in Sports Science & Physical Education from Aristotle University (2012) and an MSc in Exercise & Health from Democritus University (2016), where his graduate work explored physiological adaptations to training across the lifespan. Now in his 15th year of practice, Giorgos pairs evidence-based coaching (ACSM-CPT, NSCA, USA Weightlifting) with a research-driven interest in how physical activity, body composition, and musculoskeletal integrity shape—and are shaped by—host–microbiome dynamics.
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Kimberly Eyer
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Kimberly Eyer
Read MoreKimberly Eyer, a Registered Nurse with 30 years of nursing experience across diverse settings, including Home Health, ICU, Operating Room Nursing, and Research. Her roles have encompassed Operating Room Nurse, RN First Assistant, and Acting Director of a Same Day Surgery Center. Her specialty areas include Adult Cardiac Surgery, Congenital Cardiac Surgery, Vascular Surgery, and Neurosurgery.
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Autoimmune Diseases
Autoimmune Diseases
Autoimmune disease is when the immune system mistakenly attacks the body's tissues, often linked to imbalances in the microbiome, which can disrupt immune regulation and contribute to disease development.
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Graves Disease
Graves Disease
OverviewGraves’ Disease (GD) affects approximately 0.5% of the population, predominantly women. First-line treatment options—antithyroid medications, radioactive iodine, and surgery— often result in significant side effects, incomplete remissions, and frequent relapses. Further, current first-line treatment options focus on symptoms management, and reflect an inadequate understanding of the etiology of the condition. However, recent research reveals a […]
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Giorgos Aristotelous
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Researched by:
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Giorgos Aristotelous
ID
Giorgos Aristotelous
Read More
Fact-checked by:
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Kimberly Eyer
ID
Kimberly Eyer
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Microbiome Signatures identifies and validates condition-specific microbiome shifts and interventions to accelerate clinical translation. Our multidisciplinary team supports clinicians, researchers, and innovators in turning microbiome science into actionable medicine.
Giorgos Aristotelous
Location
China
Sample Site
Feces
Species
Homo sapiens
What was studied?
This original research article investigated the differences in gut microbial composition and predicted microbial metabolic functions between patients with Graves’ disease (GD), those with Graves’ orbitopathy (GO), and healthy controls. Using 16S rRNA gene sequencing, the study sought to identify specific gut microbiota signatures and metabolic pathway alterations associated with each disease state, with the focus keyphrase “gut microbiota in Graves’ disease and Graves’ orbitopathy.” The study aimed to enhance understanding of the relationship between the gut microbiome and the pathophysiology of GD and GO, and to explore whether distinct microbial and metabolic profiles could help distinguish GD from GO in clinical practice.
Who was studied?
The study population consisted of 30 patients with GD (without GO), 33 patients with GO, and 32 healthy controls, all recruited from the Department of Endocrinology at Beijing Tongren Hospital, Capital Medical University, China, between 2017 and 2019. Participants were matched for age and sex where possible. Inclusion criteria for GD and GO were based on established clinical guidelines, with GO diagnosed according to the EUGOGO criteria. Participants with recent probiotic or antibiotic use, hormonal medication, gastrointestinal disease, major systemic illness, pregnancy, or substance abuse were excluded. All GD and GO patients were on antithyroid medications and had normal FT3 and FT4 levels at enrollment. The selected cohorts were designed to minimize confounding factors and ensure differences in gut microbiota were attributable to disease status.
Most important findings
The study revealed that both GD and GO patients exhibited significantly reduced gut microbial diversity compared to healthy controls, as shown by the Shannon index, indicating dysbiosis in disease states. Beta-diversity analysis demonstrated distinct clustering of microbial communities among the three groups. At the phylum level, GO patients had a significant decrease in Deinococcus-Thermus and Chloroflexi compared to GD patients, while GO patients also showed increased Bacteroidetes and decreased Firmicutes relative to controls. At the genus level, GO patients exhibited higher levels of Subdoligranulum and Bilophila and lower levels of Blautia, Anaerostipes, Dorea, Butyricicoccus, Romboutsia, Fusicatenibacter, unidentified Lachnospiraceae and Clostridiales, Collinsella, Intestinibacter, and Phascolarctobacterium compared to GD. Several taxa, particularly Subdoligranulum and unidentified Lachnospiraceae, showed strong associations with TRAb levels (thyrotrophin receptor antibody) in both GD and GO, suggesting a potential link between specific gut bacteria and disease immunopathology. Random forest analysis identified Deinococcus-Thermus, Cyanobacteria, and Chloroflexi as top taxa for distinguishing between groups. Functionally, predicted KEGG pathway analysis indicated that both GD and GO patients’ gut microbiota were enriched for nucleotide metabolism, energy metabolism, and enzyme family pathways compared to controls. A unique enrichment of viral protein family pathways was observed in GD compared to GO, aligning with hypotheses about viral triggers in autoimmunity.
Key implications
This study provides robust evidence that the gut microbiota in Graves’ disease and Graves’ orbitopathy is altered in both composition and predicted metabolic function, with distinct microbial signatures for each condition. The identification of specific taxa (e.g., Deinococcus-Thermus, Chloroflexi, Subdoligranulum, and Lachnospiraceae) that differentiate GD from GO and their association with TRAb levels may offer new biomarkers for disease stratification and risk assessment. The functional enrichment of nucleotide and energy metabolism pathways and the unique viral protein family pathway in GD suggest that the gut microbiome may contribute to disease mechanisms and progression. These findings support the potential for microbiome-based diagnostic tools and therapeutic strategies targeting gut microbial modulation in the management of Graves’ disease and its extrathyroidal manifestations.