背景:肠道菌群的组成和结构变化与过敏性紫癜(HSP)的发病状况密切相关。
目的:调查有或没有胃肠道(GI)受累的HSP患者的临床指标和肠道菌群是否不同,并探讨有或没有胃肠道症状的HSP儿童粪便菌群的变化。
方法:共22名HSP患儿纳入研究。通过16SrRNA测序分析粪便微生物群组成。临床指标,粪便微生物多样性,比较两组的成分。
结果:分别,纳入9例胃肠道受累患者(HSP-A)和13例无胃肠道受累患者(HSP-N)。前白蛋白(PA)和免疫球蛋白A(IgA)/补体(C)3的比率在HSP-A组中明显降低,而在HSP-N组中发现D-二聚体升高。布劳蒂亚的相对丰富,落叶螺旋体,与HSP-N相比,HSP-A组的嗜血杆菌明显更高。较低水平的未鉴定的Prevotellaceae,副杆菌属,在HSP-A患者中发现了Romboutsia。线性判别分析效应大小(LEfSe)显示HSP-A组的生物标志物包括Blautia,厌氧症,Veillonella,落叶螺旋体,和嗜血杆菌.对于HSP-N组,身份不明的Prevotellaceae,肠杆菌,Romboutsia,和Akkermansia是属水平上突出的生物标志物。此外,IgA/C3的比值与布劳特氏菌属呈负相关。同时,PA与Veillonella呈负相关。
结论:这些结果为未来基于微生物的疗法提供了更广泛的理解,以减少胃肠道受累的发展并改善儿童HSP的临床结局。
BACKGROUND: The compositional and structural changes of gut microbiota were closely related to the status of Henoch-Schönlein purpura (HSP).
OBJECTIVE: To investigate if clinical indicators and gut microbiota differ between HSP patients with or without gastrointestinal (GI) involvement and to explore the alterations of fecal microbiota in HSP children with and without GI symptoms.
METHODS: A total of 22 children with HSP were enrolled in the study. Fecal microbiota composition was analyzed by 16S rRNA sequencing. Clinical indicators, fecal microbial diversity, and compositions were compared between the two groups.
RESULTS: Respectively, 9 patients with GI involvement (HSP-A) and 13 patients without GI involvement (HSP-N) were enrolled. Prealbumin (PA) and the ratio of immunoglobulin A (IgA) / complement (C)3 were significantly decreased in the HSP-A group and an elevated D-dimer was found in the HSP-N group. The relative abundances of Blautia, Lachnospira, and Haemophilus were significantly higher in the HSP-A group compared to HSP-N. Lower levels of unidentified Prevotellaceae, Parabacteroides, and Romboutsia were found in HSP-A patients. The linear discriminant analysis effect size (LEfSe) showed that the biomarkers for the HSP-A group included Blautia, Anaerostipes, Veillonella, Lachnospira, and Haemophilus. For the HSP-N group, unidentified Prevotellaceae, Intestinibacter, Romboutsia, and Akkermansia were the prominent biomarkers at the genus level. Additionally, the ratio of IgA/C3 exhibited a negative correlation with the genus Blautia. Meanwhile, PA showed negatively correlation with Veillonella.
CONCLUSIONS: These results provide a broader understanding for future microbial-based therapies to decrease the development of GI involvement and improve the clinical outcome of HSP in children.