| Objective:Psoriasis vulgaris is a common refractory dermatosis,with a long course of disease and recurs easily,which causing tremendous physical and mental harm to patients.Its incidence is increasing year by year.However,its pathological mechanism is still unclear.At present,exploring the relationship between human health and disease from the intestinal microecology has increasingly become the focus of medical research.More and more evidence show that the disturbance of intestinal flora plays an important role in the occurrence and development of diseases.This research is based on the combination of disease and syndrome of traditional Chinese medicine,using advanced technology to explore the gut microbiota dysbiosis in patients with psoriasis,the blood heat syndrome and the blood dryness syndrome of psoriasis.This research is aimed to reveal the gut microbiota characteristics and pathological mechanism of different TCM syndromes,and provide a basis for expanding and deepening the TCM diagnosis and treatment of psoriasis and discover new therapy targets,which may also lay a foundation for the optimization of the TCM diagnosis and treatment of psoriasis.Methods:In this study,30 patients with psoriasis were included in the skin clinic of Beijing Hospital of Traditional Chinese Medicine,which including 15 patients with syndrome of blood-heat and 15 patients with syndrome of blood-dryness,the control group consists of 15 healthy person.Diagnostic,inclusion and exclusion criteria were established,and all cases are evaluated by at least two deputy chief physicians or experts with higher professional titles according to the above criteria.Comprehensive oral explanations were given and signed informed consent was obtained from all study subjects,and clinical information were either collected.Then,the stool samples would be retained.We use metagenome sequencing technology to detect the diversity index and composition of bacterial of all the samples,and explore the differences of gut microbiota in patients with psoriasis and healthy people,as well as the characteristics and mechanisms of different TCM syndromes.Results:1.30 patients with psoriasis vulgaris(15 cases of blood-heat syndrome and 15 cases of blood-dryness syndrome)and 15 healthy individuals were included in this study.There were no significantiy differences in gender,age and BMI among the three groups,and the PSAI is similar between the two groups of psoriasis patients.The gender,age,and BMI had no significant effect on the composition of the three groups(P>0.05).A total of 212.4G of raw sequencing data was obtained from 45 samples.Reads of the samples were between 21200856-92428544,with an average of 33794591.All samples had sufficient sequencing depth.2.Patients with psoriasis had no significant difference in species diversity compared with:the healthy control group(P>0.05).At the phylum level,Euryarchaeota in psoriasis group was significantly reduced(P=0.017<0.05).The abundance of Firmicutes was slightly higher,and that Bacteroidetes was slightly lower.Other bacteria such as Pasteurellales,Rikenellaceae,Porphyromonadaceae and Alistopes showed a significant decrease in the psoriasis group(P<0.05).3.Compared with the healthy individuals,the species richness of the blood-heat group and blood-dryness group were decreased.There diversity index showed no significant difference.The abundance of Citrobacter and Roseburia inulinivorans in the intestinal flora of the blood-heat group were significantly increased compared with the healthy individuals(P<0.05).Moreover,the abundance of Odoribacter splanchnicus and Lactobacillaceae was significantly reduced(P<0.05).Intestinal flora such as Selenomonadales,Negativicutesin and Megamonas funiformis in the blood-dryness group were significantly higher than that in healthy individuals(P<0.05),while the abundance of Porphyromonadaceae,Dialister and Bacteroides intestinalis were significantly reduced(P<0.05).4.Compared with the blood-heat group,the diversity index of the blood-dryness group showed no significant difference.The abundances of Eubacterium and Dialister of the blood-dryness group were significantly reduced(P<0.05).Conclusion:Compared with healthy individuals,the gut microbiota of patients with psoriasis has been changed.The gut microbiota of patients with different TCM syndromes has its own unique characteristics,which patients with blood-dryness syndrome showed worse dysbiosis than patients with blood-heat syndrome.Antibiotic,probiotic,and Facal microbiota transplantation may be the potential treatments for psoriasis.The treatment of patients with blood-dryness syndrome is recommended to add drugs for invigrating spleen and benefiting bowel and relieving the depressed liver. |
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