Fig. 2

Dysbiosis correlates with gastrointestinal and some extraintestinal manifestations of SSc, but not disease subtype or immunosuppressive therapy. Dysbiosis was prevalent in patients with both short and long disease duration (a), lcSSc and dcSSc (b) as well as in patients with and without immunosuppressive therapy (c), with no significant differences between groups. Dysbiosis was more pronounced in patients with gastrointestinal manifestations of SSc including pathological oesophageal function, p = 0.036 (d); at risk for malnutrition, p = 0.005 (e); low levels of P-transthyretin, p = 0.045 (f); increased levels of F-calprotectin, p < 0.001 (g); gastrointestinal symptoms present, p = 0.019 (h) or micronutrient deficiency p = 0.009 (i). Also, patients with pulmonary fibrosis, p = 0.009 (j); telangiectasias, p = 0.020 (k); or pitting scars, p = 0.023 (l) had more pronounced dysbiosis compared to other patients. dcSSc diffuse cutaneous SSc, F-calprotectin faecal calprotectin, lcSSc limited cutaneous SSc, MUST Malnutrition Universal Screening Tool