基于中医学“皮肠同病”理论探讨肠道菌群与白癜风的因果关系:两样本孟德尔随机化分析  

Discussion of causal relationship between intestinal flora and vitiligo based on"co-diseases of skin and gut"in TCM:two-sample mendelian randomization analysis

作　　者：黄安宁 杨建仁 赵锦鹏 徐国梅 Huang Anning;Yang Jianren;Zhao Jinpeng;Xu Guomei(Master Degree Student of Grade 2022,Beijing University of Chinese Medicine,Beijing 100029,China;Department of Dermatology,the Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学第三附属医院皮肤性病科,北京100029

出　　处：《国际中医中药杂志》2025年第3期306-311,共6页International Journal of Traditional Chinese Medicine

摘　　要：目的基于中医学“皮肠同病”理论,采用两样本孟德尔随机化(MR)分析探讨肠道菌群与白癜风的因果关系。方法检索MiBioGen数据库、IEU OpenGWAS Proiect数据库肠道菌群样本、白癜风样本的全基因组关联研究(GWAS)数据。以肠道菌群作为暴露因素,白癜风作为结局,与各类肠道菌群相关的单核苷酸多态性(SNP)作为工具变量。筛选合格的工具变量后,采用逆方差加权法(IVW)进行MR分析,以MR-Egger回归、加权中位数法(WME)、加权众数法(WM)、简单众数法(SM)作为IVW补充方法;采用Cochram's Q检验、MR-Egger截距测试、MR-PRESSO法、留一法进行敏感性分析。结果广古菌门(Euryarchaeota)(IVW法:OR<1,P<0.05)是白癜风发生的保护因子;Clostridialesvadin-BB60group(IVW法:OR>1,P<0.05)、罕见小球菌属(Subdoligranulum)(IVW法:OR>1,P<0.05)是白癜风发生的危险因子。Cochran's Q检验未发现异质性效应(P>0.05);MR-Egger截距测试未发现水平多效性(P>0.05),MR-PRESSO法分析未发现离群值(P>0.05);留一法分析结果提示,已鉴定的3个肠道菌群与白癜风之间的因果效应不受任何单个的SNP驱动。结论部分肠道菌群与白癜风之间存在因果效应,但具体机制仍需进一步研究。肠道菌群影响白癜风的发病及治疗,中医药调节肠道微生态可能对治疗白癜风有良好疗效,为临床白癜风诊疗提供方向。Objective To analyze the causal relationship between intestinal flora and vitiligo by two-sample Mendelian randomization(MR)analysis based on"co-diseases of skin and gut"in TCM.Methods Genome-wide association study(GWAS)data of intestinal flora samples and vitiligo samples were obtained from the databases of MiBioGen and IEU OpenGWAS Project,respectively.Intestinal flora was used as exposure factor,vitiligo as outcome,and single nucleotide polymorphism(SNP)associated with various intestinal floras was used as instrumental variable.After screening qualified instrumental variable in this study,inverse variance weighting(IVW)was used for MR analysis to investigate the potential causal relationship between intestinal flora and vitiligo,MR-Egger regression,weighted median estimator(WME),weighted mode(WM),and simple mode(SM)were used as supplementary methods for IVW.The Cochran's Q test,MR-Egger intercept test,MR-PRESSO and leave one-out analysis were used for sensitivity analysis.Results Euryarchaeota(IVW method:OR<1,P<0.05)were the protective factors for the occurrence of vitiligo,and Clostridialesvadin-BB60group(IVW method:OR>1,P<0.05)and Subdoligranulum(IVW method:OR>1,P<0.05)were the risk factors for the occurrence of vitiligo.No heterogeneity effect was found by the Cochran's Q test(P>0.05),no horizontal pleiotropy was found by the MR-Egger intercept test(P>0.05),no outliers were found in the MR-PRESSO analysis(P>0.05),and the results of leave-one-out analysis indicated that the causal effects of the 3 identified intestinal floras on vitiligo were not driven by any single SNP.Conclusions There are causal effects between some intestinal floras and vitiligo,but the specific mechanisms still need to be further studied.The gut microbiota affects the onset and treatment of vitiligo.Using TCM to regulate the gut microbiota may have a good therapeutic effect on treating vitiligo,providing a direction for clinical diagnosis and treatment of vitiligo.

关 键 词：白癜风 肠道菌群 皮肠同病 因果效应 孟德尔随机化分析 

分 类 号：R75[医药卫生—皮肤病学与性病学]