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Response to antihistamines in post-burn pruritus is associated with gut microbiota composition and function: A
YeonGyun Jung1, SoHyun Yeo2, Ryeong-Hui Kim3
1Burn Institute, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07247, Republic of Korea.
Summary
Gut microbes influence antihistamine response in post-burn pruritus (PBP). Specific gut bacteria and functions differ between patients who respond to antihistamines and those who do not, suggesting new therapeutic targets for PBP.
Area of Science:
- Microbiology
- Dermatology
- Gastroenterology
Background:
- Post-burn pruritus (PBP) is a common, variable complication of burn injuries.
- Antihistamine treatment efficacy varies significantly among PBP patients.
- Gut microbiota alterations are linked to histamine intolerance, but their role in PBP antihistamine response is unknown.
Purpose of the Study:
- To investigate the relationship between gut microbiome composition and antihistamine responsiveness in PBP patients.
- To identify distinct microbial signatures associated with different levels of pruritus and treatment response.
Main Methods:
- 16S rRNA gene sequencing of fecal samples from 56 male burn patients (no-pruritus, antihistamine-responsive, antihistamine-nonresponsive).
- Functional microbiome prediction using PICRUSt2.
- Analysis of microbial changes after 8 weeks of antihistamine treatment.
Main Results:
- No significant differences in overall microbial diversity between groups.
- Antihistamine-responsive (HR) group showed increased Sutterella, temporal increases in diversity and Bifidobacterium, and enriched redox functions.
- Antihistamine-nonresponsive (HNR) group exhibited increased Akkermansia and Acidaminococcus, reduced antioxidant defenses, and activated non-histaminergic pathways.
Conclusions:
- Gut microbiota composition and function are associated with antihistamine responsiveness in PBP.
- Distinct microbial and functional profiles differentiate non-pruritic, HR, and HNR patients.
- Findings suggest gut microbes play a role in PBP pathophysiology and may offer microbiota-targeted therapeutic strategies.
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