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Updated: Jan 27, 2026

A Data-Driven Approach to Quantifying Immune States in Sepsis
Published on: February 7, 2025
The Mediating Role of Immune Cells in the Genetically Predicted Relationship between Gut Microbiota and Puerperal
Yihui Chai1, Chunsong Gu2, Zhiliang Fan1
1School of Basic Medicine, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China.
Background:
The causal relationship between gut microbiota and puerperal sepsis (PS) remains unclear, and there is a lack of in-depth research regarding the potential mediating role of immune cells in this context.
Objective:
This study aims to investigate the causal relationship between gut microbiota and PS using Mendelian randomization (MR) analysis and to assess the mediating effects of immune cells on the risk of PS onset through mediation analysis.
Materials And Methods:
We selected data from large-scale genome-wide association studies (GWAS) involving 473 gut microbiota species, 731 immune cell phenotypes, and PS datasets. Univariate MR (UVMR) analysis was employed to explore the causal relationship between gut microbiota and PS, with the primary statistical method being inverse variance weighting (IVW). Multiple statistical models were applied for sensitivity analysis to minimize the confounding effects of horizontal pleiotropy and heterogeneity. Subsequently, a two-step mediation MR analysis was conducted to evaluate whether immune cells mediate the relationship between gut microbiota and PS.
Results And Discussion:
Analysis using various statistical models indicated that 11 gut microbiota species (e.g., Azorhizobiume, Bacillus velezensis, CAG-245 sp000435175, Lentimicrobiaceae, and Providencia) exhibited a causal relationship with PS. Further reverse causal analysis between PS and gut microbiota ruled out the possibility of reverse causality. The two-step mediation MR analysis demonstrated that the percentage of IgD-CD27- B cells (10.26%) and CD62L- monocytes (17.29%) partially mediated the effect of CAG-245 sp000435175 on PS risk.
Conclusion:
This study provides evidence of a causal relationship between the abundance of certain gut microbiota species and PS, while also revealing a potential mediating role of immune cells. These findings offer valuable theoretical insights into personalized treatment strategies and the development of novel diagnostic biomarkers for PS.
Insights
Certain gut bacteria are causally linked to puerperal sepsis (PS). Immune cells, specifically IgD-CD27- B cells and CD62L- monocytes, partially mediate this risk, offering insights into PS development.
Area of Science:
- Microbiome research
- Immunology
- Genetics
Background:
- The link between gut microbiota and puerperal sepsis (PS) is not well understood.
- The role of immune cells in mediating this relationship requires further investigation.
Purpose of the Study:
- To investigate the causal relationship between gut microbiota and PS using Mendelian randomization (MR).
- To assess the mediating role of immune cells in the development of PS.
Main Methods:
- Utilized large-scale genome-wide association studies (GWAS) data for gut microbiota, immune cell phenotypes, and PS.
- Employed univariate Mendelian randomization (UVMR) with inverse variance weighting (IVW) and sensitivity analyses.
- Conducted two-step mediation Mendelian randomization (MR) analysis to explore mediation pathways.
Main Results:
- Identified 11 gut microbial species with a causal association with PS, including Azorhizobiume and Bacillus velezensis.
- Confirmed no reverse causality between PS and gut microbiota.
- Found that IgD-CD27- B cells (10.26%) and CD62L- monocytes (17.29%) partially mediated the effect of CAG-245 sp000435175 on PS risk.
Conclusions:
- Established a causal link between specific gut microbiota and PS.
- Demonstrated a mediating role for certain immune cell populations in PS pathogenesis.
- Findings may inform personalized PS treatments and biomarker development.
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