ORIGINAL RESEARCH article
Front. Immunol.
Sec. Multiple Sclerosis and Neuroimmunology
Dysbiosis of intestinal microbiota in patients with neuromyelitis optica spectrum disorders
Provisionally accepted
- West China Hospital, Sichuan University, Chengdu, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Abstract Objective This study aimed to explore the specific microbial signatures and metabolomic profiles of fecal microbiota in patients with neuromyelitis optica spectrum disorders (NMOSD) and assess the effects of immunosuppressants on their gut microbiota using a longitudinal cohort study. Methods We enrolled 21 treatment-naïve NMOSD patients and 21 matched healthy controls (HCs). Fecal microbial composition and metabolomic profiles were compared between groups using 16S rRNA gene sequencing and ultra-high-performance liquid chromatography-mass spectrometry. Subsequently, fecal samples from NMOSD patients were collected and reassessed after immunosuppressant treatment. Results The gut microbial composition and metabolomic profiles of NMOSD patients were distinct from those of HCs. The α-diversity metrics were significantly higher in NMOSD patients than in HCs (P <0.001). Microbiome alterations in NMOSD patients were characterized by increased abundances of Streptococcus and Ruminococcus, and decreased abundances of Faecalibacterium, Ralstonia, and Pseudomonas at the genus level (all with linear discriminant analysis scores > 4 and P < 0.001). Additionally, Phylogenetic Investigation of Communities by Reconstruction of Unobserved States analysis identified 19 differentially abundant metabolites and 44 altered metabolic pathways in NMOSD patients compared to HCs. Immunosuppressive treatment for over six months may reduce these differences, shifting the gut microbiota composition and metabolite profiles of NMOSD patients closer to those of HCs. Interpretation Our study revealed significant gut microbiome dysbiosis and metabolic abnormalities in patients with NMOSD, which were markedly alleviated after six months of immunosuppressive treatment. These preliminary findings suggest the gut microbiota biomarkers could serve as potential therapeutic targets in the future.
Keywords: Dysbiosis, Gut Microbiota, Immunosuppressant, metabolomic profiles, neuromyelitis optica spectrum disorders
Received: 16 Nov 2025; Accepted: 04 Feb 2026.
Copyright: © 2026 Du, Wang, Shi, Chen, Zhang, wang, Mou, Kong and Zhou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hongyu Zhou
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.