# Gut microbiome alterations in immune thrombocytopenia: a systematic review of current evidence

## TL;DR

This review examines how gut microbiome changes might be linked to immune thrombocytopenia, an autoimmune disease affecting platelet production.

## Contribution

The study systematically reviews current evidence on gut microbiome alterations in immune thrombocytopenia, highlighting inconsistencies and potential therapeutic implications.

## Key findings

- Studies show significant alterations in gut microbiota composition in ITP patients.
- Findings on specific phyla like Bacteroidetes and Proteobacteria are inconsistent across studies.
- Alpha and beta diversity results are conflicting, indicating a need for further research.

## Abstract

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.