Preliminary Study On The Changes Of Intestinal Bacterial Flora In Patients With Androgenetic Alopecia And Alopecia Areata Before And After Treatment

Objective:To analyze and compare the differences between patients with alopecia disease(androgenetic alopecia,alopecia areata)and healthy normal people in Sichuan by high-throughput sequencing technology,to explore the possible association between intestinal bacterial flora and the occurrence and development of alopecia diseases,and to study the changes in the intestinal bacterial flora of patients before and after treatment,and to observe the mechanism of the drug regulating the intestinal flora to achieve curative effect from the microscopic level.Methods:From February 2021 to July 2021,11 patients with androgenetic alopecia and 9 patients with alopecia areata were collected,a total of 20 patients,and 10 healthy volunteers during the same period were selected as the control healthy normal group.Questionnaire was used to collect clinical data,and gross and dermoscopic images were taken,and to detect the levels of testosterone(Testo),prolactin(PRL)or antinuclear antibody(ANA),serum total Ig E,thyroid function and thyroid autoantibodies.The feces before and after treatment were collected,and the 16 S r RNA gene high-throughput sequencing method was used to analyze and compare the composition and differences of intestinal bacterial flora among the groups.Results:1.Patients with androgenetic alopecia had obvious family history.People with alopecia areata are more likely to have trouble in sleeping,and people with androgenetic alopecia are more likely to have an oily scalp.There were no statistically significant differences in the influencing factors of intestinal flora such as age,gender,dietary preference,and living environment among the groups,suggesting that this study is feasible.2.The androgenetic alopecia group,alopecia areata group,and healthy normal group were different in the number distribution of ASVs,and there were significant differences,but there were also shared ASVs,suggesting that most of the bacterial flora in different groups were the same and also had their own unique bacteria group.3.Alpha diversity analysis: The Chao1 index and PD index of the androgenetic alopecia group before and after treatment were statistically significant compared with the healthy normal group(P < 0.01,P < 0.05).There was no statistical significance in Shannon index(P>0.05),indicating that the androgenetic alopecia group had significant differences in the richness and evenness of flora before and after treatment with the healthy normal group,and there was no significant change in bacterial flora after treatment.There was no significant difference in the flora richness and evenness between the alopecia areata group and the healthy normal group before and after treatment.4.Beta diversity analysis: The distribution of samples in each group has a certain concentration and a certain degree of dispersion,indicating that there are differences between different groups,and there is a unique and similar intestinal flora structure between different groups.Separation within the same group may be more factors affecting the composition of individual gut communities.5.The androgenetic alopecia group,the alopecia areata group,and the healthy normal group had similar species abundance at the phylum,class,order,family,and genus level,but the proportions were different.At the phylum level,Bacteroidetes and Firmicutes are the most abundant species of adult intestinal bacterial flora.6.Compared with healthy normal people,patients with androgenetic alopecia have higher abundances of Staphylococcus of Firmicutes,Bacteroidetes,Acinetobacter and Xanthobacter of Proteobacteria,The abundances of [Eubacterium] ruminantium group of Firmicutes and Thaumarchaeota were lower;after treatment,the abundance of Prevotella of Bacteroidetes and Flavonifractor of Firmicutes was significantly up-regulated,Ruminococcaceae of Firmicutes,Acinetobacter of Proteobacteria and Staphylococcus of Firmicutes were significantly down-regulated.7.Compared with healthy people,patients with alopecia areata have higher abundances of Catenibacterium of Firmicutes,Bacteroides of Bacteroidetes,Bifidobacterium of Actinobacteria,and Prevotella of Bacteroidetes,Blautia of Firmicutes,Candidatus Udaeobacter of Verrucomicrobia were lower in abundance;the abundance of Veillonella,Rosella,Ruminobacteria of Firmicutes and Proteobacteria was significantly up-regulated after treatment.Conclusion:1.The species richness of intestinal bacterial flora in patients with androgenetic alopecia is significantly lower than that of normal people,and the species with differences are Bacteroidetes,Staphylococcus,Acinetobacter,Xanthobacter,[Eubacterium]ruminantium group,Thaumarchaeota;species richness did not change significantly after treatment,still lower than normal people,Prevotella,Flavonifractor,Ruminococcaceae,Acinetobacter,Staphylococcus had differences after treatment,and these differential species may be regulatory points for anti-androgen therapy.2.There is no significant difference in the species richness of intestinal bacterial flora between patients with alopecia areata and normal people,but the species with differences are Catenibacterium,Bacteroides,Bifidobacterium,Prevotella,Blautia,Candidatus Udaeobacter;Veillonella,Rosella,Ruminobacteria,Proteobacteria were different after treatment.One of the mechanisms of treatment for alopecia areata may be by changing the distribution of butyric acid-producing bacteria to achieve the curative effect.3.Patients with alopecia disease can formulate specific bacterial species for individualized treatment according to the composition of the existing intestinal flora and problematic bacteria,or restore the intestinal microecological balance with the help of fecal microbiota transplantation,which is beneficial to the long-term development of alopecia patients and moving in the direction of relief and healing.