Zhongguo quanke yixue (Jun 2023)
Intestinal Flora in Children with Henoch-Schönlein Purpura Nephritis: Composition and Abundance Analysis and Clinical Significance
Abstract
Background The number of studies about the status of intestinal flora in children with Henoch-Sch?nlein purpura (HSP) is limited, and there are no reports on changes of intestinal flora in children with Henoch-Sch?nlein purpura nephritis (HSPN) at the early stage of the disease. Objective To investigate the changes of intestinal flora in HSPN children and their association with the development of the disease. Methods Thirty-seven newly treated children with HSP (test group) were selected from Department of Pediatrics, the First Affiliated Hospital of Zhengzhou University from July to September 2019, and compared to 12 healthy children (control group) in terms of the status of intestinal flora. The test group was further divided into non-renal injury subgroup (13 cases) and renal injury subgroup (24 cases) according to the prevalence of renal injury during a 6-month follow-up. General data and stool specimens were collected from the affected children and healthy children. High-throughput sequencing was used to sequence and analyze the intestinal flora of all subjects. Alpha diversity (Shannon index, Chao1 index, ACE index) analysis was used to explore the richness and diversity of the microbial communities within the samples. Principal coordinate analysis (PCoA) was used to explore the differences in community structure among the groups, linear discriminant analysis effect size (LEfSe) analysis were used to identify species with significant differences. Results Alpha diversity analysis results showed that there was no statistically significant difference in Shannon index, Chao1 index and ACE index among the three groups (P>0.05). PCoA showed that the composition of intestinal flora varied across renal injury and non-renal injury subgroups and the control group (P<0.05). Further Adonis analysis revealed that the intestinal flora composition varied significantly between non-renal injury subgroup and the control group (F=2.172, P=0.006), and between renal injury subgroup and the control group (F=2.217, P=0.006), as well as between renal injury and non-renal injury subgroups (F=1.590, P=0.045). LEfSe analysis showed, compared with the control group, the test group had significantly decreased abundance of Blautia, Chryseobacterium, Agathobacter and Roseburia (P<0.05), and significantly increased abundance of Megamonas and Enterococcus (P<0.05). Compared with non-renal injury subgroup, renal injury subgroup had significantly reduced abundance of Christensenella and Bacteroides (P<0.05), and significantly increased abundance of Lactobacillus and Rothia (P<0.05) . Conclusion Intestinal flora disorders were found in HSP children, the intestinal flora of children with HSPN at the early stage of the disease were different from those of HSP children without renal injury, suggesting that the intestinal flora disorder at the early stage of the disease may be closely related to the development of HSPN.
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