GTX-GUT: A Standardized Metagenomic Workflow for Gut Microbiome Profiling and Clinical Associations

Abstract

The human gut microbiome plays a central role in host physiology and disease, yet metagenomic analysis pipelines remain fragmented across sample preparation, taxonomic classification, and clinical interpretation stages, complicating reproducibility and translational use. Here we present GTX-GUT, a fully automated, containerized Snakemake pipeline for 16S rRNA gut microbiome profiling that integrates quality control, taxonomic classification (QIIME2/DADA2 against Greengenes 13.8), diversity and compositional metrics benchmarked against a curated healthy reference population, enterotype classification, a clinical association module spanning 11 disease categories, and automated natural-language report generation. We validated the pipeline using the ZymoBIOMICS mock community, showing that BBDuk preprocessing substantially reduced genus-level quantification error (Mean Absolute Error reduced from 7.34 to 1.58 percentage points; Pearson's $r$ improved from 0.576 to 0.833). Application to a human sample from a patient with type 2 Diabetes Mellitus recovered a dysbiotic signature consistent with the literature, including reduced Firmicutes abundance, elevated Bacteroidetes and Proteobacteria, and a predominance of clinical associations within metabolic and gastrointestinal categories. These results demonstrate that GTX-GUT provides a reproducible, end-to-end framework linking raw sequencing data to clinically interpretable output, with direct applicability to research and translational microbiome studies.