Khiabani Alireza, Khalilabadi Roohollah Mirzaee, Valandani Hajar Mardani, Khoshnegah Zahra, Khanahmad Alireza, Shahraki Hojat, Nezamabadipour Najmeh, Farsinejad Alireza, Rahimlou Mehran
Student Research Committee, Faculty of Allied Medicine, Kerman University of Medical Sciences, Kerman, Iran.
Department of Hematology and Medical Laboratory Sciences, Faculty of Allied Medicine, Kerman University of Medical Sciences, Kerman, Iran.
Front Med (Lausanne). 2025 May 16;12:1511612. doi: 10.3389/fmed.2025.1511612. eCollection 2025.
Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by immune-mediated platelet destruction and impaired platelet production. Recent evidence suggests a role for gut microbiome dysbiosis in autoimmune diseases, but its association with ITP remains unclear. This systematic review explores the potential link between the gut microbiome and ITP pathophysiology.
We conducted a comprehensive search in five databases (MEDLINE, Scopus, Web of Science, Cochrane Library, Embase) from 1980 to July 2024, adhering to PRISMA 2020 guidelines. Studies assessing the gut microbiome in patients with ITP were included. The primary outcome was alterations in gut microbiota composition, and study selection was performed in three phases, with discrepancies resolved through consensus.
From 480 studies screened, 12 met the inclusion criteria. The studies revealed significant alterations in gut microbiota composition, particularly at the phylum level. An increase in Bacteroidetes and Proteobacteria was observed in some studies, while others reported a decrease in these phyla. Firmicutes showed inconsistent results across studies. Alpha and beta diversity analysis also yielded conflicting results, with some studies reporting decreased diversity, while others found no significant difference or an increase.
The results suggest a potential link between gut microbiota dysbiosis and ITP, though findings remain inconsistent across studies. Further well-designed research is needed to clarify the role of the microbiome in ITP, with implications for novel therapeutic approaches.
免疫性血小板减少症（ITP）是一种自身免疫性疾病，其特征为免疫介导的血小板破坏和血小板生成受损。最近的证据表明肠道微生物群失调在自身免疫性疾病中起作用，但其与ITP的关联仍不明确。本系统评价探讨肠道微生物群与ITP病理生理学之间的潜在联系。
我们按照PRISMA 2020指南，在1980年至2024年7月期间对五个数据库（MEDLINE、Scopus、Web of Science、Cochrane图书馆、Embase）进行了全面检索。纳入评估ITP患者肠道微生物群的研究。主要结局是肠道微生物群组成的改变，研究选择分三个阶段进行，差异通过共识解决。
在筛选的480项研究中，12项符合纳入标准。这些研究揭示了肠道微生物群组成的显著改变，尤其是在门水平。一些研究观察到拟杆菌门和变形菌门增加，而其他研究报告这些门减少。厚壁菌门在各研究中的结果不一致。α和β多样性分析也得出了相互矛盾的结果，一些研究报告多样性降低，而其他研究未发现显著差异或多样性增加。
结果表明肠道微生物群失调与ITP之间可能存在联系，尽管各研究结果仍不一致。需要进一步设计良好的研究来阐明微生物群在ITP中的作用，这对新的治疗方法具有启示意义。
