儿科偏头痛的特征是生态和代谢失调以及炎症的特征。

Pediatric migraine is characterized by traits of ecological and metabolic dysbiosis and inflammation.

机构信息

Developmental Neurology Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio, 4, Rome, Italy.

Immunology, Rheumatology and Infectious Diseases Research Area, Unit of Microbiome, Bambino Gesù Children's Hospital, IRCCS, Viale Di San Paolo, 15, Rome, Italy.

出版信息

J Headache Pain. 2024 Oct 9;25(1):171. doi: 10.1186/s10194-024-01871-7.

DOI:10.1186/s10194-024-01871-7

PMID:39379796

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11462686/

Abstract

BACKGROUND

Recently, there has been increasing interest in the possible role of the gut microbiota (GM) in the onset of migraine. Our aim was to verify whether bacterial populations associated with intestinal dysbiosis are found in pediatric patients with migraine. We looked for which metabolic pathways, these bacteria were involved and whether they might be associated with gut inflammation and increased intestinal permeability.

METHODS

Patients aged between 6 and 17 years were recruited. The GM profiling was performed by the 16S rRNA metataxonomics of faecal samples from 98 patients with migraine and 98 healthy subjects. Alpha and beta diversity analyses and multivariate and univariate analyses were applied to compare the gut microbiota profiles between the two group. To predict functional metabolic pathways, we used phylogenetic analysis of communities. The level of indican in urine was analyzed to investigate the presence of metabolic dysbiosis. To assess gut inflammation, increased intestinal permeability and the mucosal immune activation, we measured the plasmatic levels of lipopolysaccharide, occludin and IgA, respectively.

RESULTS

The α-diversity analysis revealed a significant increase of bacterial richness in the migraine group. The β-diversity analysis showed significant differences between the two groups indicating gut dysbiosis in patients with migraine. Thirty-seven metabolic pathways were increased in the migraine group, which includes changes in tryptophan and phenylalanine metabolism. The presence of metabolic dysbiosis was confirmed by the increased level of indican in urine. Increased levels of plasmatic occludin and IgA indicated the presence of intestinal permeability and mucosal immune activation. The plasmatic LPS levels showed a low intestinal inflammation in patients with migraine.

CONCLUSIONS

Pediatric patients with migraine present GM profiles different from healthy subjects, associated with metabolic pathways important in migraine.

摘要

背景

最近，人们对肠道微生物群（GM）在偏头痛发病中的可能作用越来越感兴趣。我们的目的是验证肠道失调相关的细菌群体是否存在于偏头痛的儿科患者中。我们寻找这些细菌参与的代谢途径，以及它们是否与肠道炎症和增加的肠道通透性有关。

方法

招募了年龄在 6 至 17 岁之间的患者。通过对 98 例偏头痛患者和 98 例健康对照者的粪便样本进行 16S rRNA 元组学分析，对 GM 进行分析。对两组肠道微生物群进行了α多样性和β多样性分析以及多元和单变量分析。为了预测功能代谢途径，我们使用群落的系统发育分析。通过分析尿液中的吲哚乙酸水平来研究代谢失调的存在。为了评估肠道炎症、增加的肠道通透性和粘膜免疫激活，我们分别测量了血浆脂多糖、闭合蛋白和 IgA 的水平。

结果

α多样性分析显示偏头痛组的细菌丰富度显著增加。β多样性分析表明两组之间存在显著差异，表明偏头痛患者的肠道失调。偏头痛组有 37 条代谢途径增加，其中包括色氨酸和苯丙氨酸代谢的变化。尿液中吲哚乙酸水平的增加证实了代谢失调的存在。血浆 occludin 和 IgA 水平的增加表明存在肠道通透性和粘膜免疫激活。血浆 LPS 水平显示偏头痛患者的肠道炎症程度较低。