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We conducted a two\u2010step, two\u2010sample Mendelian randomization study using an inverse variance\u2010weighted approach to investigate the causal role of the gut microbiota in ITP and the mediating effect of inflammatory cytokines on their association. The results showed that among the 473 gut microbiota species, 11 were positively associated and 12 were negatively associated with the risk of ITP. Among the 91 screened inflammatory cytokines, five (CXCL10, CXCL5, IL\u201012RA, TRAIL, and VEGF\u2010A) were found to have a causal relationship with ITP. Mediation analysis revealed that the gut microbiota UBA1066 promoted the occurrence of ITP through CXCL10 mediation, with a mediation effect of 0.118932 (95% CI: 0.049471\u20130.188393) accounting for 9.95% of the total effect. Gut microbiota <jats:italic>Treponema<\/jats:italic> promoted ITP through VEGF\u2010A mediation, with a mediation effect of 0.045873 (95% CI: 0.01456\u20130.07718) accounting for 4.28% of the total effect. Gut microbiota <jats:italic>Haloplasma<\/jats:italic> promoted the occurrence of ITP via CXCL5. The mediating effect of CXCL5 was 0.038409 (95% CI\u2009=\u20090.00107718\u20130.07575082), with a mediating ratio of 16.79%. This study revealed a causal relationship between gut microbiota composition and ITP risk, highlighting three inflammatory cytokines as potential causal mediators of this relationship. These findings provide potential targets and biomarkers for the prevention and treatment of ITP with significant clinical implications.<\/jats:p>","DOI":"10.1111\/ejh.14310","type":"journal-article","created":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T01:59:56Z","timestamp":1728439196000},"page":"120-128","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Impact of Gut Microbiota and Inflammatory Cytokines on Immune Thrombocytopenia"],"prefix":"10.1111","volume":"114","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7775-3308","authenticated-orcid":false,"given":"Ji\u2010Gan","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Pediatrics Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Guangxi Clinical Research Center for Pediatric Diseases  Nanning 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