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Gut Microbiota Dysbiosis in Childhood Vasculitis: A Perspective Comparative Pilot Study
Marianna Fabi1, Federica D'Amico2, Silvia Turroni3
1Pediatric Emergency Unit, Department of Medical and Surgical Sciences, IRCCS Azienda Ospedaliero-Universitaria, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy.
Insights
Gut microbiota alterations are linked to childhood vasculitis like Kawasaki disease (KD) and Henoch-Schönlein purpura (HSP). Beneficial gut bacteria were reduced in KD and HSP patients, suggesting new therapeutic targets.
Area of Science:
- Pediatric Rheumatology
- Microbiology
- Immunology
Background:
- Kawasaki disease (KD) and Henoch-Schönlein purpura (HSP) are common childhood vasculitides.
- A multifactorial etiology involving genetic predisposition and immune dysregulation is suspected.
- Gut microbiota (GM) alterations may trigger or exacerbate the hyperimmune response in these conditions.
Purpose of the Study:
- To investigate the gut microbiota composition in children with KD.
- To compare the GM profiles of KD patients with those of HSP patients and febrile controls.
- To identify potential GM signatures associated with KD and HSP.
Main Methods:
- 16S rRNA gene sequencing was employed to profile the gut microbiota.
- Children diagnosed with KD, HSP, and febrile illness (F) were enrolled.
- GM profiles were compared against healthy control cohorts from previous studies.
Main Results:
- Gut microbiota composition significantly differed between KD, HSP, and febrile children compared to controls.
- A reduction in the relative abundance of beneficial Ruminococcaceae and Lachnospiraceae families was observed in patients.
- Distinct GM signatures were identified, including lower levels of Dialister in KD and Clostridium/Akkermansia in HSP. Dysbiosis was more pronounced in patients with abdominal involvement.
Conclusions:
- This study provides the first analysis of GM in a predominantly Caucasian cohort of KD and HSP children.
- Alterations in gut microbiota composition are associated with childhood vasculitis.
- Findings suggest potential GM-targeted therapeutic strategies for KD and HSP.
Abstract:
Kawasaki disease (KD) and Henoch-Schönlein purpura (HSP) are the most frequent vasculitis in childhood. For both, a multifactorial mechanism has been hypothesised, with an abnormal immune response in genetically predisposed children. Gut microbiota (GM) alterations might trigger the hyperimmune reaction. Our aim was to explore the GM in KD and compare it with the GM of HSP and febrile children. Children diagnosed with KD, HSP and non-KD febrile illness (F) were enrolled. GM was profiled by 16S rRNA gene sequencing and compared with the profiles of healthy children from previous studies. We enrolled 13 KD, 10 HSP and 12 F children. Their GM significantly differed from controls, with an overall reduction in the relative abundance of beneficial taxa belonging to the Ruminococcaceae and Lachnospiraceae families. Potential KD and HSP signatures were identified, including smaller amounts of Dialister in the former, and Clostridium and Akkermansia in the latter. Notably, the GM structures of KD, HSP and F patients stratified by abdominal involvement, with more severe dysbiosis in those suffering from intestinal symptoms. This is the first study analysing GM in a mostly Caucasian cohort of KD and HSP children. Our data could open up new opportunities for childhood vasculitis treatment.
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