Gut Microbiota Differences Among Patients With Burns With Varied Pruritus Responses: A Case Report

Pruritus-a common symptom in patients with burns-impairs the quality of life and contributes to anxiety and depression. Although the mechanisms underlying postburn pruritus remain unclear, gut microbiome dysbiosis may affect systemic inflammation and drug responsiveness. This study analyzed the gut microbiome composition of 6 male patients (40-50 years old) with burns and categorized them into 3 groups based on pruritus outcomes-nonpruritus (NP, did not receive antihistamine), responder (R, pruritus reduced with antihistamine treatment), and nonresponder (NR, pruritus persisted despite antihistamine treatment). Fecal samples were collected at baseline (week 0) and after 8 weeks. The NP and R groups exhibited enhanced alpha diversity, increased Firmicutes/Bacteroidota (F/B) ratios, and reduced Proteobacteria over time, indicating microbiome recovery. In contrast, the NR group exhibited inconsistent results, with case 5 demonstrating reduced diversity and increased F/B and Proteobacteria, whereas case 6 exhibited increased diversity and decreased F/B and Proteobacteria. Faecalibacterium was absent in the NR group, whereas the relative abundance of unclassified Lachnospiraceae increased. This study highlights the potential effects of dysbiosis on pruritus outcomes and drug responsiveness in patients with burns. Future studies with larger cohorts are necessary to assess these findings and explore microbiome-targeted therapies to enhance treatment outcomes.