特应性皮炎患儿与健康儿童肠道菌群、炎症因子水平的差异分析

Differences in gut microbiota and inflammatory factor levels between children with atopic dermatitis and healthy controls

摘要:

目的 探讨特应性皮炎患儿与健康儿童肠道菌群及炎症因子水平的差异。方法 选取2022年1月—2024年1月在宁波大学附属第一医院接受治疗的116例特应性皮炎患儿作为观察组；另选取同期在该院接受体检的102例健康儿童作为对照组。收集两组粪便样本，利用16S rRNA测序技术和Qiime软件进行肠道菌群α多样性分析［Chao1、observed species（Sobs）、Shannon、Simpson指数］，并通过酶联免疫吸附试验检测炎症因子水平［白细胞介素-4（IL-4）、IL-13、IL-31］。通过Pearson法分析肠道菌群多样性与炎症因子水平的相关性，并采用受试者工作特征（ROC）曲线分别评估肠道菌群α多样性、炎症因子水平对特应性皮炎患儿的诊断价值。结果 观察组Chao1、Sobs、Shannon和Simpson指数均低于对照组（P <0.05）。观察组IL-4、IL-13和IL-31水平均高于对照组（P <0.05）。Pearson相关性分析显示，Chao1、Sobs、Shannon、Simpson指数与IL-4、IL-13和IL-31水平均呈负相关（P <0.05）。ROC曲线分析结果显示，联合诊断的敏感性为98.3%（95% CI：0.939，0.998），特异性为98.0%（95% CI：0.931，0.998），曲线下面积为0.973（95% CI：0.946，1.000），且均较单一指标检测高。结论 特应性皮炎患儿会出现肠道菌群α多样性降低及炎症因子水平升高，联合检测可提高特应性皮炎的诊断效能。

Abstract:

Objective To investigate the differences in gut microbiota and inflammatory factor levels between children with atopic dermatitis and healthy controls.Methods A total of 116 children with atopic dermatitis who received treatment in the First Affiliated Hospital of Ningbo University from January 2022 to January 2024 were selected as the observation group, and 102 healthy children who underwent health checkups at the hospital during the same period were enrolled as the control group. Fecal samples from both groups were collected, and 16S rRNA sequencing and Qiime software were used to analyze the α-diversity of gut microbiota, including Chao1 index, number of observed species (Sobs), Shannon index, and Simpson index. Enzyme-linked immunosorbent assay (ELISA) was employed to detect the levels of inflammatory factors, including interleukin-4 (IL-4), IL-13, and IL-31. Pearson correlation analysis was performed to explore the relationship between gut microbiota diversity and inflammatory factor levels, and receiver operating characteristic (ROC) curves were applied to evaluate the diagnostic value of gut microbiota α-diversity and inflammatory factor levels for children with atopic dermatitis, respectively.Results The Chao1, Sobs, Shannon, and Simpson indices in the observation group were significantly lower than those in the control group (P <0.05), while the levels of IL-4, IL-13 and IL-31 were significantly higher in the observation group (P < 0.05). Pearson correlation analysis revealed negative correlations between gut microbiota α-diversity indices and serum inflammatory factor levels (P < 0.05). ROC curve analysis indicated that the combination of gut microbiota α-diversity and inflammatory factors for diagnosing atopic dermatitis yielded a sensitivity of 98.3% (95% CI: 0.939, 0.998), with a specificity of 98.0% (95% CI: 0.931, 0.998) and an area under the curve of 0.973 (95% CI: 0.946, 1.000), outperforming each individual marker.Conclusion Children with atopic dermatitis exhibit reduced gut microbiota α-diversity and elevated inflammatory factor levels, and combined detection of these indicators can enhance the diagnostic efficacy for atopic dermatitis.