REVIEW article
Front. Immunol.
Sec. Microbial Immunology
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1595977
This article is part of the Research TopicHost-Microbiota Immuno-Interactions for Personalized Microbial TherapeuticsView all 8 articles
The gut-immune axis in primary immune thrombocytopenia (ITP): a paradigm shifts in treatment approaches
Provisionally accepted
- 1Puyang Oil Field General Hospital, Puyang, Henan, China
- 2University Hospital of Bern, Bern, Bern, Switzerland
- 3University of California, San Diego, La Jolla, United States
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Primary immune thrombocytopenia (ITP) is an autoimmune disorder characterized by platelet destruction and impaired production, leading to bleeding risk. While immunosuppressive therapies are standard, many patients experience relapses or refractory disease, highlighting the need for novel approaches. Emerging evidence suggests the gut microbiota plays a role in immune regulation, yet its impact on ITP remains unclear. Dysbiosis has been linked to immune dysfunction in other autoimmune diseases, but whether it drives or results from immune dysregulation in ITP is debated. This review explores the gut-immune axis in ITP, focusing on microbiota-driven immune modulation, cytokine signaling, and platelet homeostasis. We assess microbiota-targeted interventions, including fecal microbiota transplantation (FMT), probiotics, and dietary modifications, while addressing key controversies and knowledge gaps. Advances in microbiome sequencing and artificial intelligence may facilitate personalized interventions. Standardizing microbiota-based diagnostics and validating their efficacy in clinical trials are crucial for their integration into ITP management. Bridging these gaps may lead to microbiota-driven strategies that enhance immune regulation and improve patient outcomes.
Keywords: Primary immune thrombocytopenia (ITP), Gut-immune axis, Immune dysregulation, Microbiota-based therapy, platelet homeostasis
Received: 19 Mar 2025; Accepted: 26 May 2025.
Copyright: © 2025 Guo, Wang, Liu, Baran and Ma. 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: Wenxue Ma, University of California, San Diego, La Jolla, United States
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