Reduced fiber intake and increased Escherichia abundance in depigmenting vitiligo patients.

Summary: Abstract Body: We invited 100 vitiligo patients and controls to fill a dietary questionnaire and donate stool and serum specimens to examine the relationship between diet, the microbiome and autoimmune disease in vitiligo. Participants from the US and Kazakhstan were separated into 3 approximately equal sized groups of individuals with active and stable disease or healthy controls, wherein activity is defined by lesional progression over the past 3 months. There were no significant differences in the healthy eating index among groups, but individual nutrients were significantly underrepresented in the diet of actively depigmenting patients compared to their stable counterparts, including fibers, fats and fatty acids, amino acids including histidine, and zinc. Microbial analysis of the stool showed no difference in alpha or beta diversity among the groups but simultaneously revealed a significant overabundance of the genera Escherichia and Odoribacter in actively depigmenting patients. Metagenome analysis of data further revealed that differences in microbial metabolism between active and stable patients were driven in part by the abundance of Escherichia species. In sera from actively depigmenting patients we found a combination of inflammatory cytokines not seen in stable patients or controls. We propose that dietary deficiencies limit the generation of SCFA and favor an increase in Escherichia in the gut, in turn promoting Odoribacter colonization. Reduced zinc can limit serotonin production, while reduced histidine uptake is not remedied by enhanced production in the gut. Combined with our ongoing studies in vitiligo-prone mice, we find that dietary factors can influence disease progression in vitiligo. Zhussipbek Mukhatayev¹, Artur Kovenskiy¹, Ziyou Ren², Stephanie Rangel², Nurlubek Katkenov¹, Yerkhanat Khuanbai¹, Yekatarina Ostapchuk¹, Ayaulum Nurgozhina¹, Stefan Green³, Roopal Kundu², Almagul Kushugulova¹, Caroline Le Poole² 1. National Laboratory Astana, Nazarbayev University, Astana, Kazakhstan. 2. Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States. 3. Internal Medicine, Rush University Medical Center, Chicago, IL, United States. Pigmentation, Melanoma, and Melanoma Immune Surveillance