If your patient has uveitis, one key to your diagnosis may be found in their stomach.

Researchers from India analyzed the gut fungal microbiome of 14 uveitis patients and compared them to samples from 24 healthy patients. They found gut fungal richness and diversity were significantly decreased in uveitis patients compared with their healthy counterparts. Additionally, investigators observed an enrichment of several pathogenic fungi, including Malassezia restricta, Candida albicans, Candida glabrata and Aspergillus gracilis in the uveitis patients.

Only patients with either autoimmune or idiopathic uveitis were included in the investigation.

Earlier studies have noted dysbiosis in the gut bacterial microbiome of rats and mice with autoimmune uveitis. This is the first study to find dysbiosis in the gut fungal communities of uveitis patients, indicating the importance of fungal microbiome in the disease pathology, researchers said.

In healthy individuals, the investigators found 24 genera of yeasts with anti-inflammatory or anti-pathogenic effects that showed an increased abundance—which they speculated could be beneficial. They also reported five of the nine fungal genera enriched in uveitis patients were opportunistic pathogens.

“These initial findings might warrant further investigation into the fungal microbiome, especially interactions between fungal and bacterial that then might give further insight into how probiotics or fecal transplants might benefit.”

The data reported in the present study are part of a larger investigation involving the comparison of variations in the gut bacterial and fungal microbiomes in healthy controls and individuals with bacterial keratitis, fungal keratitis and uveitis.

Jayasudha R, Kalyana Chakravarthy S, Sai Prashanthi G, et al. Implicating dysbiosis of the gut fungal microbiome in uveitis, an inflammatory disease of the eye. Invest Ophthalmol Vis Sci. 2019;60(5):1384-93.