Effects of changes on gut microbiota in children with acute Kawasaki disease

Abstract

Background Kawasaki disease (KD) is an acute febrile illness of early childhood. The exact etiology of the disease remains unknown. At present, research on KD is mostly limited to susceptibility genes, infections, and immunity. However, research on the correlation between gut microbiota and KD is rare. Methods Children with a diagnosis of acute KD and children undergoing physical examination during the same period were included. At the time of admission, the subjects’ peripheral venous blood and feces were collected. Faecal samples were analyzed for bacterial taxonomic content via high-throughput sequencing. The abundance, diversity, composition, and characteristic differences of the gut microbiota in KD and healthy children were compared by alpha diversity, beta diversity, linear discriminant analysis and LDA effect size analysis. Blood samples were used for routine blood examination, biochemical analysis, and immunoglobulin quantitative detection. Results Compared with the control group, the community richness and structure of gut microbiota in the KD group was significantly reduced (Chao1 richness estimator, mean 215.85 in KD vs. mean 725.76 in control, p < 0.01; Shannon diversity index, mean 3.32 in KD vs. mean 5.69 in control, p < 0.05). LEfSe analysis identified two strains of bacteria significantly associated with KD: Bacteroidetes and Dorea. Bacteroidetes were enriched in healthy children (mean 0.16 in KD vs. mean 0.34 in control, p < 0.05). Dorea was also enriched in healthy children but rarely existed in children with KD (mean 0.002 in KD vs. mean 0.016 in control, p < 0.05). Compared with the control, IgA and IgG in the KD group decreased (IgA, median 0.68 g/L in KD vs. median 1.06 g/L in control, p < 0.001; IgG, median 6.67 g/L in KD vs. median 9.71 g/L in control, p < 0.001), and IgE and IgM levels were not significantly changed. Conclusions Dysbiosis of gut microbiota occurs in children with acute KD and may be related to the etiology or pathogenesis of KD. It is worth noting that for the first time, we found that Dorea, a hydrogen-producing bacterium, was significantly reduced in children with acute KD. Overall, our results provide a theoretical basis for the prevention or diagnosis of KD based on intestinal microecology.

Gut Microbiota Dysbiosis in Childhood Vasculitis: A Perspective Comparative Pilot Study

“…Consistent with the existing literature on the GM of Asian subjects with KD and HSP [ 22 , 23 , 24 , 25 ], all study patients, compared to an age/gender-matched cohort of HC, showed some imbalances, including especially low proportions of typically health-associated and short-chain fatty acid (SCFA)-producing taxa, such as those belonging to the Lachnospiraceae and Ruminococcaceae families. However, it must be said that the decrease in SCFA producers is a common sign of dysbiosis, shared by various (enteric and non-enteric) diseases, possibly related to the presence of oxidative stress [ 40 ].…”

“…Furthermore, patients with F showed a low relative abundance of Collinsella . It should be noted that such potential signatures are different from those identified in previous studies [ 22 , 23 , 24 , 25 ], potentially being related to ethnicity and geographical effect, which are recognised as the main drivers of GM variation [ 27 , 44 ]. As for Collinsella and Dialister , they are genera typically represented in the infant GM as they are involved in the lactate cycle (lactose utiliser and lactate producer the first, lactate utiliser the second) [ 44 , 45 ].…”

“…It has recently become obvious that GM alterations can cause immune dysregulation, contributing to a plethora of disorders, both intestinal and systemic, such as inflammatory bowel, allergic and autoimmune diseases [ 17 , 18 , 19 , 20 , 21 ]. Regarding childhood vasculitis, a number of studies have explored GM in Asian KD and HSP cohorts, highlighting potentially common features, such as reduced microbial diversity (common marker of dysbiosis) and reduced proportions of health-associated and anti-inflammatory taxa (e.g., Lachnospiraceae and Ruminococcaceae members) compared to healthy subjects [ 22 , 23 , 24 , 25 ]. The loss of GM homeostasis was also corroborated by the increase in pathobionts (mainly Enterococcus ) in both KD and HSP [ 24 , 25 ].…”

Findings on the Relationship Between Intestinal Microbiome and Vasculitis

“…The intestinal microbiome affected by the environment was found to play a role in KD development ( Esposito et al., 2019 ; Rhim et al., 2019 ). Bacteroidetes and Dorea are significantly associated with KD ( Shen et al., 2020 ); Fusobacteria , Shigella , and Streptococcus also probably contribute to the onset of KD ( Khan et al., 2020 ). The abundance of Ruminococcus is relatively increased during non-acute KD, whereas that of Streptococcus is relatively increased during acute KD ( Kinumaki et al., 2015 ).…”

Update in the Relationship between Gut Microbiota and Kawasaki Disease

“…These suggest a possible interaction between the altered gut microbiota and the occurrence of KD, confirming the association between antibiotic administration and KD pathogenesis, which may promote the development of KD by affecting the gut microbiota in infants and young children. In addition, it is the first study to report [15] that the hydroproducer Dorea is significantly reduced in children with acute KD, and in short, intestinal microbiosis exists in children with acute KD.…”