Unveiling the gut-heart potential connection: microbiota's role in kawasaki disease and coronary artery lesions.

BACKGROUND

Kawasaki disease (KD) is an acute systemic immune vasculitis predominantly affecting medium and small arteries, commonly observed in pediatric patients. It represents the most common form of acquired heart disease in this population. Emerging evidence suggests that gut microbiota can modulate the gut-vascular axis, influencing coronary artery lesions (CALs). This study aims to elucidate the potential association between gut microbiota, KD, and CALs, as well as identify bacterial biomarkers for CALs.

METHODS

We analyzed the gut microbiota composition of 60 children with KD (15 in the acute phase, 45 in the nonacute phase) and 30 healthy controls using alpha diversity indices and t-tests. Microbial biomarkers were identified through LEfSe to analyze the interplay between gut microbiota and CALs in KD during acute and non-acute phases.

RESULTS

In the acute phase, KD children exhibited decreased richness and diversity of gut microbiota, characterized by dysbiosis, particularly a reduction in short-chain fatty acid-producing bacteria and overgrowth of opportunistic pathogens. Thirteen genera showed statistically significant changes, including , etc. LEfSe analysis revealed enrichment of in patients with concurrent CALs, while was depleted. In the nonacute phase, gut microbiota diversity was similar to healthy controls, but was upregulated, while and were downregulated. CALs were associated with reduced . LEfSe analysis also showed enrichment of , and in patients with CALs.

CONCLUSIONS

Our findings provide evidence of gut microbiota dysbiosis in KD children, suggesting its involvement in CALs development. It indicates that under the premise of standardized treatment during the acute phase of KD, it is plausible that microbiota-targeted strategies may alleviate CALs, thereby improving patient prognosis.