SYSTEMATIC REVIEW article
Front. Med.
Sec. Hematology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1511612
This article is part of the Research TopicImmune Thrombocytopenia (ITP) - Diagnosis and Treatment - Volume IIView all 7 articles
Gut Microbiome Alterations in Immune Thrombocytopenia: A Systematic Review of Current Evidence
Provisionally accepted
Mehran Rahimlou1*
Alireza Khiabani2
Roohollah Mirzaee Khalilabadi2
Hajar Mardani Valandani2
Zahra Khoshnegah2
Alireza Khanahmad2Hojat Shahraki3Najmeh Nezamabadipour4Alireza Farsinejad2- 1Zanjan University of Medical Sciences, Zanjān, Iran
- 2Kerman University of Medical Sciences, Kerman, Kerman, Iran
- 3Shahid Beheshti University of Medical Sciences, Tehran, Tehran, Iran
- 4Bam University of Medical Sciences and Health Services, Bam, Fars, Iran
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Background: 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.Methods: 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.Results: 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.Conclusion: 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.
Keywords: immune thrombocytopenia, gut microbiome, Dysbiosis, Autoimmune Diseases, Microbial Diversity
Received: 15 Oct 2024; Accepted: 16 Apr 2025.
Copyright: © 2025 Rahimlou, Khiabani, Khalilabadi, Valandani, Khoshnegah, Khanahmad, Shahraki, Nezamabadipour and Farsinejad. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mehran Rahimlou, Zanjan University of Medical Sciences, Zanjān, Iran
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