AUTHOR=Khiabani Alireza , Khalilabadi Roohollah Mirzaee , Valandani Hajar Mardani , Khoshnegah Zahra , Khanahmad Alireza , Shahraki Hojat , Nezamabadipour Najmeh , Farsinejad Alireza , Rahimlou Mehran 

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

JOURNAL=Frontiers in Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1511612

DOI=10.3389/fmed.2025.1511612

ISSN=2296-858X

ABSTRACT=BackgroundImmune 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.MethodsWe 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.ResultsFrom 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.ConclusionThe 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.