Dysbiosis of gut microbiome contributes to glaucoma pathogenesis

Abstract Microbiome dysfunction is considered to contribute to the pathogenesis of many neurodegenerative diseases. However, the relationship between the gut microbiome and glaucoma, a neurodegenerative disorder remains largely unknown. Here, we identified that the gut microbiome of glaucoma patients were rich in Dysgonamonadaceae, along with a lower level of Barnesiellaceae by metagenomic sequencing. This microbiome pattern is shown to increased the production of short chain fatty acids (SCFAs) in the fecal and blood samples. Reducing these glaucoma‐specific gut microbiome bacteria significantly reduced retinal ganglion cell (RGC) loss by alleviating the activation of retinal microglia cells and overproduction of inflammatory cytokines in acute glaucoma mouse model, whereas SCFAs treatment aggravated microglia activation. Mechanistically, reducing the glaucoma‐specific gut microbiome bacteria decreased the retinal microRNA profile including MiR‐122‐5p, which led to neuroprotection through inhibition of retinal inflammation. We validated our results by showing that fecal microbiome transplantation from glaucoma patients significantly exacerbated retinal microglia activation and increased retinal inflammation. Our findings indicate that the change of gut microbiome is associated with glaucoma, by activation of retinal microglia and changing expression of retinal microRNAs, leading to retinal inflammation reaction and RGC loss. The gut microbiome may be a new target for the neuroprotection in glaucoma.