Department of Pediatrics, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Dermatology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Front Cell Infect Microbiol. 2022 Mar 16;12:831489. doi: 10.3389/fcimb.2022.831489. eCollection 2022.
Chronic spontaneous urticaria (CSU) is a histamine-mediated inflammatory skin disease, and second-generation non-sedating H1-antihistamines (nsAH) at licensed doses have long been the first-line therapy in CSU. However, about 50% of patients are resistant to nsAH, and the precise pathogenesis remains largely unknown but seems to be associated with low-level systemic or intestinal inflammation. We aim to determine the fecal microbial composition and clarify its correlation with the clinical profiles og CSU with nsAH resistance.
A total of 25 CSU patients with or 19 CSU patients without nsAH resistance and 19 healthy controls (HC) were enrolled in this study. The intestinal microbiome was detected by 16S rRNA sequencing. The data were analyzed using language software.
Significantly higher urticarial activity score for 7 days, stool calprotectin, erythrocyte sedimentation rate, serum C-reactive protein, and interleukin-6, but much lower alpha-diversity and evenness of fecal bacterial community were observed in CSU patients with nsAH resistance than in those without ( <0.05 for all variables). Compared to patients with nsAH-responsiveness, the abundance of fecal genera , , and were significantly increased, while that of , , , and were remarkably reduced in nsAH-resistant patients (uncorrected <0.05 for all variables). Finally, systemic not intestinal inflammation degree was positively correlated with genera , while negatively with genera , , , , and . CSU without nsAH resistance and HC individuals showed almost unchanged genera bacterium.
Among CSU patients, pro-inflammation phenotype relating to enteric dysbacteriosis features nsAH resistance in CSU patients. The results provide clues for future microbial-based or anti-inflammatory therapies on nsAH resistant CSU.
慢性自发性荨麻疹（CSU）是一种由组胺介导的炎症性皮肤病，在许可剂量下使用第二代非镇静 H1 抗组胺药（nsAH）一直是 CSU 的一线治疗方法。然而，约 50%的患者对 nsAH 耐药，确切的发病机制仍知之甚少，但似乎与低水平的全身或肠道炎症有关。我们旨在确定粪便微生物组成，并阐明其与 nsAH 耐药性 CSU 临床特征的相关性。
本研究共纳入 25 例有或 19 例无 nsAH 耐药性的 CSU 患者和 19 例健康对照者（HC）。采用 16S rRNA 测序检测肠道微生物组。使用 语言软件分析数据。
与无 nsAH 耐药性的 CSU 患者相比，nsAH 耐药性 CSU 患者的 7 天荨麻疹活动评分、粪便钙卫蛋白、红细胞沉降率、血清 C 反应蛋白和白细胞介素-6 显著升高，粪便细菌群落的 alpha 多样性和均匀度显著降低（所有变量的校正值均<0.05）。与 nsAH 反应性患者相比，nsAH 耐药性患者粪便属的丰度显著增加，而属的丰度显著降低（所有变量的未校正 值均<0.05）。最后，全身炎症程度与属呈正相关，与属呈负相关。nsAH 无耐药性 CSU 患者和 HC 个体的细菌组成几乎不变。
在 CSU 患者中，与肠道菌群失调相关的促炎表型与 CSU 患者的 nsAH 耐药性有关。这些结果为未来基于微生物或抗炎的 nsAH 耐药性 CSU 治疗提供了线索。
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