Analysis of gut microbiota variations in patients with Henoch-Schönlein purpura: a comprehensive systematic review.

Objective: The primary purpose of our study was to perform a comprehensive systematic review, aiming to bring out the association between gut microbiota, Henoch-Schönlein Purpura (HSP) and Henoch-Schönlein nephritis (HSPN) patients.

Methods: A systematic review was performed using five electronic databases, including Medline (through PubMed), Scopus, Embase, Cochrane, and Web of Science, from inspection up to March 21, 2024, to detect the studies that assessed the gut microbiota variation in Henoch-Schönlein Purpura (HSP) and Henoch-Schönlein nephritis (HSPN) patients.

Results: Microbial diversity, richness, and composition in HSP patients are decreased compared to the healthy control group. In addition, HSP patients display a different microbiota structure and show a significant difference in taxonomic abundance between HSP and health control, which differs from one level to another. At the phylum level, Bacteroidetes, Fusobacteria, and Blastocladiomycota were more abundant; at the class level, Bacteroidetes were more abundant; at the order level, Bacteroidetes were more abundant in the HSP group-stage and site of HSP involvement effect on microbiota. Gastrointestinal tract involvement is characterized by increased abundance of Streptococcus and Fusobacteria and a decrease in Faecalibacterium. Kidney involvement is characterized by increased abundance of Streptococcus spp, which can be used as an indicator of disease severity. Escherichia-Shigella can be used as a diagnostic for the recurrence of HSP because its abundance is higher than primary HSP.

Conclusion: Gut microbiota can be utilized to assess the severity, recurrence, and site of HSP infection by analyzing the diversity, richness, and abundance of specific microorganisms associated with the condition.