Intestinal Flora In Children With Henoch-sch(?)nlein Purpura Of Different Clinical Phenotypes

Objective:In this experiment,by examining the changes of intestinal microflora in children with different clinical phenotypes of HSP,we initially explored whether the changes in intestinal microbiota participated in the occurrence and development of HSP and organ damage.It provides a new theoretical basis for us to find and study the etiology,pathogenesis and treatment of HSP.Methods:Collected from May 2018 to May 2019,Jiangxi Provincial Children's Hospital for the first time and diagnosed with a total of 30 children with HSP,including pure purpura type(group B),gastrointestinal bleeding type(group C),kidney injury type(group D)10 cases of children,with 10 healthy children's stool as control group(group A),extraction of stool DNA,high-throughput sequencing of the V4 region of 16 S rRNA gene,and bioinformatics analysis.The levels of IL-6,IL-8 and IL-10 in the serum of the subjects were detected by ELISA method,and the levels of serum IgA,IgG,IgM and IgE were detected by Siemens automatic immunochemi-luminescence method.The Spearman correlation analysis method was used to explore the correlation between intestinal flora and inflammatory factors.Results:Compared with healthy children,in children with renal injury HSP,the abundance of Prevotella(family to species level),Gemmiger(genus to species level),Fusobacterium(order to genus level),Barnesiellaceae increased significantly,while the abundance of Lactobacillales and Bifidobacterium decreased significantly;In children with gastrointestinal bleeding HSP,the abundance of Proteobacteria,Deltaproteobacteria,Desulfovibrioaceae(order to family level),Oscillospira and Parabacteroides significantly increased,while the abundance of Bifidobacteria(order to family level),Streptococcus(phylum to family level)significantly reduced(P <0.05);in the pure purpura type HSP,the abundance of Bifidobacterium(phylum to genus level)significantly reduced(P<0.05);Compared with children with pure purpura type HSP,in children with renal injury HSP,the abundance of Prevotellaceae and Barnesiellaceae significantly increased;and in children with gastrointestinal bleeding HSP,the abundance of Fusobacterium(phylum to genus level)significantly increased.Compared with children with gastrointestinal bleeding HSP,in children with renal injury type HSP,the abundance of Gemmiger(genus to species level)was significantly higher,while the abundance of Proteobacteria was significantly lower(P <0.05).According to the correlation analysis of Spearman,the serum IgA level of children with HSP was positively correlated with the Gemmiger,and negatively correlated with Fusobacterium,while the IgG was negatively correlated with Fusobacterium and Bacteroides,IgM and Bifidobacterium(P <0.05).Conclusion:Children with different clinical phenotypes have different intestinal flora disorders,and changes in intestinal flora in children with HSP have a certain relationship with the clinical phenotype of HSP;Intestinal flora in children with HSP has an immune response to the body Certain relationship.