Table 4_Characterization of the aqueous humor microbiome in Posner–Schlossman syndrome: an exploratory metagenomic sequencing study.docx

ObjectiveThis study aims to characterize the aqueous humor (AH) microbiome in Posner–Schlossman syndrome (PSS) patients and evaluate its potential as a diagnostic and therapeutic target.
MethodsMetagenomic next-generation sequencing (mNGS) was performed on 59 AH samples from patients diagnosed with PSS (n = 28) and myopia patients who underwent intraocular lens (ICL) implantation (n = 31). Taxonomic profiling and diversity analyses were conducted to characterize the microbial communities. Interactions among microbial community members were evaluated using correlation analyses.
ResultsKey findings revealed that intraocular microbiomes existed in both normal and diseased eyes; however, PSS patients exhibited lower microbial diversity (Shannon index, p = 0.066; Simpson index, p = 0.065) and distinct community structures (PERMANOVA, p = 0.05). Disease-specific microbial signatures were identified: Paeniglutamicibacter was uniquely enriched in the PSS group, whereas Escherichia coli dominated in the ICL group. Moreover, ecological network analysis demonstrated contrasting interaction patterns. The microbiomes in the PSS group formed stable, tightly connected networks with balanced positive/negative correlations, whereas those in the ICL group exhibited antagonistic relationships, suggesting competitive exclusion. These results challenge the traditional view of ocular sterility and reveal dynamic microbiome shifts associated with PSS pathogenesis. The enrichment of Paeniglutamicibacter in PSS may represent an associated microbial signature that could potentially reflect compensatory responses to chronic inflammation, although experimental validation is needed to confirm this hypothesis.
ConclusionOur study provides preliminary evidence supporting the concept of intraocular microbiome dysbiosis in PSS, which requires validation in future studies. These findings suggest that potential microbial biomarkers warrant further investigation for their diagnostic and therapeutic implications.

研究目的：本研究旨在明确Posner-Schlossman综合征（Posner–Schlossman syndrome, PSS）患者房水（aqueous humor, AH）的微生物组特征，并评估其作为诊断与治疗靶点的潜力。
研究方法：本研究对59份房水（aqueous humor, AH）样本开展宏基因组下一代测序（metagenomic next-generation sequencing, mNGS），其中纳入28例确诊为Posner-Schlossman综合征（PSS）的患者样本，以及31例行人工晶状体（intraocular lens, ICL）植入术的近视患者样本。通过分类学特征分析与多样性分析，以解析微生物群落的组成特征，并借助相关性分析评估群落内微生物成员间的相互作用。
研究结果：核心研究结果显示，正常眼与病变眼均存在眼内微生物组；但PSS患者的微生物多样性更低（香农指数（Shannon index）：p=0.066；辛普森指数（Simpson index）：p=0.065），且群落结构存在显著差异（置换多元方差分析（PERMANOVA）：p=0.05）。本研究鉴定出疾病特异性微生物特征：Paeniglutamicibacter在PSS组中特异性富集，而大肠埃希菌（Escherichia coli）在ICL组中占主导地位。此外，生态网络分析揭示了两组截然不同的相互作用模式：PSS组的微生物组形成了稳定且紧密连接的网络，正负相关性处于平衡状态；而ICL组的微生物组则呈现拮抗关系，提示存在竞争性排斥。上述结果挑战了"眼内无菌"的传统观点，并揭示了与PSS发病机制相关的微生物组动态变化。PSS组中Paeniglutamicibacter的富集或可代表一种相关微生物特征，其可能反映机体对慢性炎症的代偿性反应，但仍需通过实验验证以确认该假说。
研究结论：本研究提供了初步证据，支持PSS存在眼内微生物组失调的观点，该结论需在未来研究中进一步验证。本研究结果提示，潜在的微生物生物标志物（microbial biomarkers）的诊断与治疗价值值得开展深入探索。