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Peer-reviewedCC BY 4.0Frontiers in Endocrinology

Gut microbiota signature in patients with Hashimoto’s thyroiditis framed in polyautoimmunity

  • Ilaria Stramazzo1,2,3
  • Simone Filardo4
  • Enke Baldini5
  • Maria Flavia Bagaglini2
  • Anna Lucia Carretti2
  • Poupak Fallahi6
  • Marisa Di Pietro7
  • Rosa Sessa7
  • Carola Severi8
  • Marco Centanni1,3
  • Camilla Virili1,3
8 affiliations
  1. 1Department of Medical-Surgical Sciences and Biotechnologies, “Sapienza” University of Rome
  2. 2Department of Experimental Medicine, “Sapienza” University of Rome
  3. 3Endocrinology Unit, Santa Maria Goretti Hospital
  4. 4Regional Department of Clinical Microbiology, University Hospital Waterford
  5. 5Department of Surgery, “Sapienza” University of Rome
  6. 6Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa
  7. 7Department of Public Health and Infectious Diseases, “Sapienza” University of Rome
  8. 8Department of Translational and Precision Medicine, “Sapienza” University of Rome
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Abstract

Background: A role for gut microbiota (GM) composition has been hypothesized in the pathogenesis and clinical presentation of different autoimmune disorders, including thyroid autoimmune diseases. No data are available about GM composition in patients showing Hashimoto’s thyroiditis (HT) associated with a further non-endocrine autoimmune disease and this was the aim of the present study.

Patients and methods: We examined the faecal microbial composition in 58 euthyroid adult patients (50F/8M) with HT subdivided in three groups: 24 with isolated HT (iHT); 22 with HT and gastric atrophy (HT+CAG) and 12 with HT and vitiligo (HT+VIT). None of the patients followed unbalanced diets, had other disorders, or used interfering drugs. Nineteen matched healthy subjects (HS) represented the control group. Microbiota composition was determined via sequencing of the hyper-variable region V3–4 of 16S rRNA gene on Illumina MiSeq platform. α- and β-diversity indices and all statistical analysis were computed in QIIME2.

Results: All patients showed increased relative abundance of Firmicutes spp. and Actinobacteria spp. (p<0.00001) and reduced relative abundance of Proteobacteria spp. and Bacteroidetes spp. compared to HS (p<0.001). Firmicutes/Bacteroidetes ratio was significantly higher in groups iHT, HT+CAG and HT+VIT than in HS (p<0.0001); to note, this ratio was higher in HT+VIT group than in iHT patients (p=0.046). α-diversity indexes (richness and phylogenetic diversity) were higher in every group than in HS (p<0.001 and p<0.0001). Phylogenetic distance (β-diversity) was clustered in all groups compared to HS. The LEfSe analysis, revealed that Lachnospiraceae, Peptostreptococcaceae and Bifidobacteriaceae, encompassing the bacterial species Fusicatenibacter saccharivorans , Anaerostipes hadrus and Blautia massiliensis , were significantly associated to patients with HT+VIT. In contrast, patients with HT+CAG were strongly associated to Lachnospiraceae and Streptococcaceae, with the prevalence of Streptococcus salivarius , whereas patients with HT were mostly associated to Blautia faecis , in accordance with ANCOM results.

Conclusions: Overall, our findings highlight significant differences in relative taxa abundances as well as phylogenetic distances of the GM communities between patients with Hashimoto’s thyroiditis isolated or associated to further autoimmune disorders (chronic atrophic gastritis or vitiligo), and healthy subjects. Interestingly, specific bacterial signatures were associated to the most common organ-specific autoimmune disorders concurrent with HT.

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Cite

BibTeXRIS
BibTeX
@article{stramazzo2026microbiota,
  title = {{Gut microbiota signature in patients with Hashimoto’s thyroiditis framed in polyautoimmunity}},
  author = {Ilaria Stramazzo and Simone Filardo and Enke Baldini and Maria Flavia Bagaglini and Anna Lucia Carretti and Poupak Fallahi and Marisa Di Pietro and Rosa Sessa and Carola Severi and Marco Centanni and Camilla Virili},
  journal = {Frontiers in Endocrinology},
  year = {2026},
  month = nov,
  doi = {10.3389/fendo.2026.1954461},
  url = {https://www.frontiersin.org/articles/10.3389/fendo.2026.1954461/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Gut microbiota signature in patients with Hashimoto’s thyroiditis framed in polyautoimmunity
AU  - Ilaria Stramazzo
AU  - Simone Filardo
AU  - Enke Baldini
AU  - Maria Flavia Bagaglini
AU  - Anna Lucia Carretti
AU  - Poupak Fallahi
AU  - Marisa Di Pietro
AU  - Rosa Sessa
AU  - Carola Severi
AU  - Marco Centanni
AU  - Camilla Virili
PY  - 2026
DA  - 2026/11/06
JO  - Frontiers in Endocrinology
DO  - 10.3389/fendo.2026.1954461
UR  - https://www.frontiersin.org/articles/10.3389/fendo.2026.1954461/full
AB  - Background: A role for gut microbiota (GM) composition has been hypothesized in the pathogenesis and clinical presentation of different autoimmune disorders, including thyroid autoimmune diseases. No data are available about GM composition in patients showing Hashimoto’s thyroiditis (HT) associated with a further non-endocrine autoimmune disease and this was the aim of the present study.  Patients and methods: We examined the faecal microbial composition in 58 euthyroid adult patients (50F/8M) with HT subdivided in three groups: 24 with isolated HT (iHT); 22 with HT and gastric atrophy (HT+CAG) and 12 with HT and vitiligo (HT+VIT). None of the patients followed unbalanced diets, had other disorders, or used interfering drugs. Nineteen matched healthy subjects (HS) represented the control group. Microbiota composition was determined via sequencing of the hyper-variable region V3–4 of 16S rRNA gene on Illumina MiSeq platform. α- and β-diversity indices and all statistical analysis were computed in QIIME2.  Results: All patients showed increased relative abundance of Firmicutes spp. and Actinobacteria spp. (p<0.00001) and reduced relative abundance of Proteobacteria spp. and Bacteroidetes spp. compared to HS (p<0.001). Firmicutes/Bacteroidetes ratio was significantly higher in groups iHT, HT+CAG and HT+VIT than in HS (p<0.0001); to note, this ratio was higher in HT+VIT group than in iHT patients (p=0.046). α-diversity indexes (richness and phylogenetic diversity) were higher in every group than in HS (p<0.001 and p<0.0001). Phylogenetic distance (β-diversity) was clustered in all groups compared to HS. The LEfSe analysis, revealed that Lachnospiraceae, Peptostreptococcaceae and Bifidobacteriaceae, encompassing the bacterial species Fusicatenibacter saccharivorans , Anaerostipes hadrus and Blautia massiliensis , were significantly associated to patients with HT+VIT. In contrast, patients with HT+CAG were strongly associated to Lachnospiraceae and Streptococcaceae, with the prevalence of Streptococcus salivarius , whereas patients with HT were mostly associated to Blautia faecis , in accordance with ANCOM results.  Conclusions: Overall, our findings highlight significant differences in relative taxa abundances as well as phylogenetic distances of the GM communities between patients with Hashimoto’s thyroiditis isolated or associated to further autoimmune disorders (chronic atrophic gastritis or vitiligo), and healthy subjects. Interestingly, specific bacterial signatures were associated to the most common organ-specific autoimmune disorders concurrent with HT.
SN  - 1664-2392
ER  -