Shen Jie, Ding Yinghe, Yang Zuocheng, Zhang Xueyan, Zhao Mingyi
Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
PeerJ. 2020 Aug 6;8:e9698. doi: 10.7717/peerj.9698. eCollection 2020.
Kawasaki disease (KD) is an acute febrile illness of early childhood. The exact etiology of the disease remains unknown. At present, research on KD is mostly limited to susceptibility genes, infections, and immunity. However, research on the correlation between gut microbiota and KD is rare.
Children with a diagnosis of acute KD and children undergoing physical examination during the same period were included. At the time of admission, the subjects' peripheral venous blood and feces were collected. Faecal samples were analyzed for bacterial taxonomic content via high-throughput sequencing. The abundance, diversity, composition, and characteristic differences of the gut microbiota in KD and healthy children were compared by alpha diversity, beta diversity, linear discriminant analysis and LDA effect size analysis. Blood samples were used for routine blood examination, biochemical analysis, and immunoglobulin quantitative detection.
Compared with the control group, the community richness and structure of gut microbiota in the KD group was significantly reduced (Chao1 richness estimator, mean 215.85 in KD vs. mean 725.76 in control, < 0.01; Shannon diversity index, mean 3.32 in KD vs. mean 5.69 in control, < 0.05). LEfSe analysis identified two strains of bacteria significantly associated with KD: and . were enriched in healthy children (mean 0.16 in KD vs. mean 0.34 in control, < 0.05). was also enriched in healthy children but rarely existed in children with KD (mean 0.002 in KD vs. mean 0.016 in control, < 0.05). Compared with the control, IgA and IgG in the KD group decreased (IgA, median 0.68 g/L in KD vs. median 1.06 g/L in control, < 0.001; IgG, median 6.67 g/L in KD vs. median 9.71 g/L in control, < 0.001), and IgE and IgM levels were not significantly changed.
Dysbiosis of gut microbiota occurs in children with acute KD and may be related to the etiology or pathogenesis of KD. It is worth noting that for the first time, we found that , a hydrogen-producing bacterium, was significantly reduced in children with acute KD. Overall, our results provide a theoretical basis for the prevention or diagnosis of KD based on intestinal microecology.
川崎病（KD）是一种幼儿期急性发热性疾病。该病的确切病因尚不清楚。目前，关于KD的研究大多局限于易感基因、感染和免疫方面。然而，关于肠道微生物群与KD之间相关性的研究却很少。
纳入诊断为急性KD的儿童和同期进行体格检查的儿童。入院时，采集受试者的外周静脉血和粪便。通过高通量测序分析粪便样本中的细菌分类学含量。采用α多样性、β多样性、线性判别分析和LDA效应大小分析比较KD患儿和健康儿童肠道微生物群的丰度、多样性、组成及特征差异。血液样本用于血常规检查、生化分析和免疫球蛋白定量检测。
与对照组相比，KD组肠道微生物群的群落丰富度和结构显著降低（Chao1丰富度估计值，KD组均值为215.85，对照组均值为725.76，<0.01；香农多样性指数，KD组均值为3.32，对照组均值为5.69，<0.05）。LEfSe分析确定了两种与KD显著相关的菌株： 和 。 在健康儿童中富集（KD组均值为0.16，对照组均值为0.34，<0.05）。 在健康儿童中也有富集，但在KD患儿中很少存在（KD组均值为0.002，对照组均值为0.016，<0.05）。与对照组相比，KD组的IgA和IgG降低（IgA，KD组中位数为0.68g/L，对照组中位数为1.06g/L，<0.001；IgG，KD组中位数为6.67g/L，对照组中位数为9.71g/L，<0.001），而IgE和IgM水平无显著变化。
急性KD患儿存在肠道微生物群失调，可能与KD的病因或发病机制有关。值得注意的是，我们首次发现急性KD患儿中产生氢气的细菌 显著减少。总体而言，我们的研究结果为基于肠道微生态的KD预防或诊断提供了理论依据。
