Cushing Syndrome Is Associated With Gut Microbial Dysbiosis and Cortisol-Degrading Bacteria
Authors' conclusion
This study provides evidence of gut microbial dysbiosis in patients with CS and identifies a group of CS-enriched bacteria capable of degrading cortisol. These findings highlight the potential role of gut microbiota in regulating host steroid hormone levels, and consequently host health.
Study context
- Population
- Patients with Cushing syndrome and healthy controls matched for age and BMImatched controls
- Participants
- 78 vs 78
- Comparison
- Cushing syndrome (CS) vs healthy controls
- CSn = 78
- Healthy controlsn = 78reference
- Outcome
- Alteration of gut microbiota in patients with CS
Methodological detailsshotgun metagenomic sequencing, controls matched for age and BMI, in vitro cortisol degradation assay
- Shotgun metagenomic sequencing
- Controls matched for age and BMI
- In vitro cortisol degradation assay
Main finding
As reported in the abstract
Gut microbial composition
- Significant differences in microbial composition between CS and controls in both sexes
- CS: reduced Bacteroidetes (Bacteroides vulgatus)
- CS: elevated Firmicutes (Erysipelotrichaceae_bacterium_6_1_45) and Proteobacteria (Enterobacter cloacae)
Observational data: associations, not effects.
Further findings
ACTH-dependent vs ACTH-independent CS
- No significant differences in metabolic profiles or gut microbiota between the 2 subgroups
Cortisol-correlated gut species
- A group of gut species, incl. R. gnavus, positively correlated with cortisol levels in CS; harbor cortisol-degrading desAB genes and consistently enriched in CS
Cortisol degradation by R. gnavus in vitro
- Efficient capacity of R. gnavus to degrade cortisol to 11-oxygenated androgens in vitro
Original publication
Cushing Syndrome Is Associated With Gut Microbial Dysbiosis and Cortisol-Degrading Bacteria. J Clin Endocrinol Metab. Published 29 December 2023. doi:10.
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