Gut microbiota alterations in children and their relationship with primary immune thrombocytopenia

Abstract

IntroductionGut microbiota reportedly play a critical role in some autoimmune diseases by maintaining immune homeostasis. Only a few studies have examined the correlation between gut microbiota and the onset of primary immune thrombocytopenia (ITP), especially in children. The purpose of this study was to investigate changes in the composition and diversity of the fecal microbiota of children with ITP, as well as the correlation between such microbiota and the onset of ITP.MethodsTwenty-five children newly diagnosed with ITP and 16 healthy volunteers (controls) were selected for the study. Fresh stool samples were collected to identify changes in the composition and diversity of gut microbiota as well as for potential correlation analysis.ResultsIn ITP patients, the phyla that were most frequently encountered were Firmicutes (54.3%), followed by Actinobacteria (19.79%), Bacteriodetes (16.06%), and Proteobacteria (8.75%). The phyla that were predominantly found in the controls were, Firmicutes (45.84%), Actinobacteria (40.15%), Bacteriodetes (3.42%), and Proteobacteria (10.23%). Compared with those of the controls, the proportions of Firmicutes and Bacteriodetes in the gut microbiota of ITP patients were increased while the proportions of Actinobacteria and Proteobacteria were decreased. Furthermore, gut microbiota in ITP patients varied by age group, showed specific changes in diversity, and were correlated with antiplatelet antibodies. IgG levels were significantly positively correlated with Bacteroides (P<0.01).ConclusionsThe gut microbiota of children with ITP are imbalanced, as shown by the increase in Bacteroidetes, which was positively correlated with IgG. Thus gut microbiota may contribute to ITP pathogenesis via IgG.Clinical Trial RegistrationThe clinical trial were registered and approved by the Institutional Review Committee of The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University. Ethics number KY-2023-106-01.

Causal relationship between gut microbiota and immune thrombocytopenia: a Mendelian randomization study of two samples

“…However, at the phylum level, we did not find any causal connections between Firmicutes and ITP risk. Another study explored the differences in gut microbiota between children with ITP and healthy individuals, and found a decrease in the proportion of Actinobacteria in the phylum level, which aligns with our findings (Li et al, 2023). There are several reasons to explain the different results, including the vulnerability Scatter plots for the causal association between gut microbiota and ITP (SNP, single nucleotide polymorphism; ITP, immune thrombocytopenia).…”

A 11-year-old boy with Blastocystis hominis infection, presents as immune thrombocytopenia

“…A study involving 16 children with ITP showed an increased abundance of Bacteroides and actinomyces in their stool compared to healthy children. This shift in population potentially contributes to the development of ITP by regulating IgG levels [ 12 ]. Remarkably, a study comparing gut flora in BH positive and BH-negative individuals reported alterations in the abundance of Bacteroides and Firmicutes in the former, resembling patterns seen in dysbiotic flora [ 13 ].…”