{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T17:43:20Z","timestamp":1792172600710,"version":"4.4.0"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"Background<\/jats:title>Alterations in the gastrointestinal (GI) microbiome (i.e., dysbiosis) are a feature of systemic sclerosis (SSc). Diet is a known modifier of the GI microbiome, and ultra-processed food (UPF) consumption has been associated with adverse changes in GI microbial composition. This study aimed to determine whether UPF consumption affects the GI microbiota and GI symptoms in patients with SSc.<\/jats:p><\/jats:sec>Methods<\/jats:title>Adult SSc patients provided stool samples and completed both the Diet History Questionnaire II (DHQ-2) and the UCLA Scleroderma Clinical Trial Consortium Gastrointestinal Tract Instrument (GIT 2.0). Shotgun metagenomics were performed using the Illumina NovaSeq 6000 with a target depth of 10 million 150x2 sequences per sample. UPF items (N=54) on the DHQ-2 were identified using the NOVA scale of food classification, and UPF intake was calculated as gram-per-week consumption according to patient reported frequency. General linear models were created to identify differentially abundant species based on UPF consumption and to evaluate the relationship between UPF consumption and GI symptoms as measured by the GIT 2.0. These models adjusted for body mass index (BMI), current proton pump inhibitor (PPI) use, current probiotic use, current or prior immunomodulatory therapy, and presence of small intestinal bacterial overgrowth (SIBO).<\/jats:p><\/jats:sec>Results<\/jats:title>Of the 65 total SSc patients included, 84.6% were female. The mean age was 53.83 \u00b1 13.19 years, and the mean BMI was 25.25 \u00b1 4.75. The median UPF consumption was 2395.82 g\/week. Increased UPF consumption was significantly associated with increased GI symptoms in our multivariate model (\u03b2=0.34; p&lt;0.01). Among 257 species analyzed, 5 bacterial species were significantly associated with UPF consumption in the multivariate models, including Limosilactobacillus<\/jats:italic> fermentum (\u03b2=0.32; p&lt;0.01) and Faecalicatena fissicatena<\/jats:italic> (\u03b2= -0.36; p-value&lt;0.01), while the abundance of 6 bacterial species was significantly associated with GI symptom severity after adjusting for the aforementioned covariates.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>SSc patients reporting a higher UPF consumption demonstrated alterations in GI microbial composition as well as increased GI symptoms, even after adjusting for factors known to affect the microbiota of patients with SSc. Future studies are needed to determine whether interventions aimed at lowering UPF consumption may improve GI outcomes for patients with SSc.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2025.1610360","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T05:27:44Z","timestamp":1759987664000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Ultra-processed food intake is associated with increased gastrointestinal tract symptoms and alterations in gut microbiota in patients with systemic sclerosis"],"prefix":"10.3389","volume":"16","author":[{"given":"Ju Young","family":"Lee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swapna","family":"Mahurkar-Joshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arissa","family":"Young","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer S.","family":"Labus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bofei","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ezinne","family":"Aja","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan P.","family":"Jacobs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth R.","family":"Volkmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0b013e32831dac75","article-title":"Lower gastrointestinal symptoms and quality of life in patients with systemic sclerosis: a population-based study","volume":"21","author":"Franck-Larsson","year":"2009","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1097\/BOR.0000000000001063","article-title":"A scoping review of the epidemiology of systemic sclerosis and its organ manifestations: 2018\u20132024","volume":"37","author":"Good","year":"2025","journal-title":"Curr Opin Rheumatol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1097\/RHU.0000000000000626","article-title":"Gastrointestinal involvement in systemic sclerosis","volume":"24","author":"Miller","year":"2018","journal-title":"J Clin Rheumatol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.110826","article-title":"Effect of gastrointestinal manifestations on quality of life in 87 consecutive patients with systemic sclerosis","volume":"39","author":"Omair","year":"2012","journal-title":"J Rheumatol"},{"key":"B5","article-title":"Correlates of depression, including overall and gastrointestinal functional status, among patients with systemic sclerosis","volume":"32","author":"Nietert","year":"2005","journal-title":"J Rheumatol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1002\/acr2.11387","article-title":"Disease features and gastrointestinal microbial composition in patients with systemic sclerosis from two independent cohorts","volume":"4","author":"Andr\u00e9asson","year":"2022","journal-title":"ACR Open Rheumatol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1186\/s13075-016-1182-z","article-title":"Intestinal dysbiosis is common in systemic sclerosis and associated with gastrointestinal and extraintestinal features of disease","volume":"18","author":"Andr\u00e9asson","year":"2016","journal-title":"Arthritis Res Ther"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1128\/mBio.01548-14","article-title":"Intestinal dysbiosis associated with systemic lupus erythematosus","volume":"5","author":"Hevia","year":"2014","journal-title":"mBio"},{"key":"B9","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1097\/MOG.0b013e328339536b","article-title":"The intestinal microbiota in inflammatory bowel diseases: time to connect with the host","volume":"26","author":"Sokol","year":"2010","journal-title":"Curr Opin Gastroenterol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"5450","DOI":"10.1038\/s41598-020-62224-3","article-title":"Implication of the gut microbiome composition of type 2 diabetic patients from northern China","volume":"10","author":"Li","year":"2020","journal-title":"Sci Rep"},{"key":"B11","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1186\/s13104-021-05466-2","article-title":"Could dysbiosis of inflammatory and anti-inflammatory gut bacteria have an implications in the development of type 2 diabetes? 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