{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T03:42:15Z","timestamp":1768707735013,"version":"3.49.0"},"reference-count":50,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,7,31]],"date-time":"2021-07-31T00:00:00Z","timestamp":1627689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["K23AR071514"],"award-info":[{"award-number":["K23AR071514"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Little is known about temporal changes in nasal bacteria in granulomatosis with polyangiitis (GPA). This study was undertaken to examine longitudinal changes in the nasal microbiome in association with relapse in GPA patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Bacterial 16S ribosomal RNA gene sequencing was performed on nasal swabs from 19 patients with GPA who were followed up longitudinally for a total of 78 visits, including 9 patients who experienced a relapse and 10 patients who remained in remission. Relative abundance of bacteria and ratios between bacteria were examined. Generalized estimating equation models were used to evaluate the association between bacterial composition and 1) disease activity and 2) levels of antineutrophil cytoplasmic antibody (ANCA) with specificity for proteinase 3 (PR3), adjusted for medication.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:italic>Corynebacterium<\/jats:italic> and <jats:italic>Staphylococcus<\/jats:italic> were the most abundant bacterial genera across all nasal samples. Patients with quiescent disease maintained a stable ratio of <jats:italic>Corynebacterium<\/jats:italic> to <jats:italic>Staphylococcus<\/jats:italic> across visits. In contrast, in patients who experienced a relapse, a significantly lower ratio was observed at the visit prior to relapse, followed by a higher ratio at the time of relapse (adjusted <jats:italic>P<\/jats:italic> &lt; 0.01). Species\u2010level analysis identified an association between a higher abundance of nasal <jats:italic>Corynebacterium tuberculostearicum<\/jats:italic> and 1) relapse (adjusted <jats:italic>P<\/jats:italic> = 0.04) and 2) higher PR3\u2010ANCA levels (adjusted <jats:italic>P<\/jats:italic> = 0.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In GPA, significant changes occur in the nasal microbiome over time and are associated with disease activity. The occurrence of these changes months prior to the onset of relapse supports a pathogenic role of nasal bacteria in GPA. Our results uphold existing hypotheses implicating <jats:italic>Staphylococcus<\/jats:italic> as an instigator of disease and have generated a novel finding involving <jats:italic>Corynebacterium<\/jats:italic> as a potential mediator of disease in GPA.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.41723","type":"journal-article","created":{"date-parts":[[2021,3,8]],"date-time":"2021-03-08T02:35:29Z","timestamp":1615170929000},"page":"1703-1712","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Dynamic Changes in the Nasal Microbiome Associated With Disease Activity in Patients With Granulomatosis With\u00a0Polyangiitis"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4907-0304","authenticated-orcid":false,"given":"Rennie L.","family":"Rhee","sequence":"first","affiliation":[{"name":"University of Pennsylvania  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