The aim of this study is to understand Chronic limb-threatening ischemia (CLTI) is a severe manifestation of peripheral artery disease (PAD) with high morbidity for aging populations. Although the metabolites produced by the intestinal microbiota have been shown to predict the long-term risk of adverse events in patients with PAD, the contribution of the blood microbiota to CLTI development has not been investigated. We profiled the blood microbiota of patients with PAD and CLTI compared with those with PAD and intermittent claudication (CLAUD) to identify any differences in microbial composition.

Blood samples were collected from patients aged 49 to 84 years with CLAUD (n = 15) or CLTI (n = 4), which had been defined by clinical symptoms and the ankle-brachial or toe-brachial index. The ethics board approved the study. The blood microbiota of the CLAUD and CLTI groups was profiled using 16S rDNA sequencing and QIIME 2 analysis (available at: Sequences were rarefied to 7962 reads/sample for Shannon diversity and principal coordinates analyses (weighted UniFrac with PERMANOVA). A multivariate linear regression model was generated using the gneiss software package to identify differentially abundant bacterial genera between the CLAUD and CLTI patients.

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