Gut microbiome associated with Graves' disease and Graves' orbitopathy: the INDIGO* multi-centre European study.

The increased F:B ratio observed in GD/GO mirrors our finding in a murine model comparing TSHR-immunized with control mice. We defined a microbiome signature and identified changes associated with autoimmunity as distinct from those due to hyperthyroidism. Persistence of TRAB is predictive of relapse, identification of these patients at diagnosis, via their microbiome, could improve management with potential to eradicate Clostridiales.