OBJECTIVE To analyze the intestinal flora distribution and expression and significance of micrornA-125B-1-3p (miR-125b-1-3p), nuclear factor E2-related factor 2 (Nrf2)/ heme oxygenase-1 (HO-1) pathway in peripheral blood of children with rotavirus-induced diarrhea (RVID), and to provide references for diagnosis and treatment of RVID in children.

METHODS Children with RVID admitted to Jinan Second Maternal and Child Health Care Hospital from Mar. 2020 to Mar. 2024 were included in the RVID group (n=104), and children with healthy check-up in the same period were selected as the control group (n=100). According to Vesikari score, children in RVID group were further divided into the mild group (n=80) and the severe group (n=24). The distribution of intestinal flora and the expression levels of miR-125b-1-3p, Nrf2 and HO-1 in peripheral blood were compared between the RVID and control groups and among RVID with different severity. Pearson correlation coefficient was used to analyze the correlation between the expression of miR-125b-1-3p, Nrf2, HO-1 and Vesikari score of RVID children.

RESULTS The strains of Escherichia coli, Bifidobacterium, Lactobacillus, Clostridium and Bacteroides in the RVID group were (7.42±0.84), (7.14±0.76), (6.36±0.72), (6.88±0.74) and (8.94±0.92) log copies/g, respectively, which were lower than those in the control group (all P < 0.05); the level of miR-125b-1-3p in the RVID group was (1.62±0.29), higher than that in control group (P < 0.05), and Nrf2 and HO-1 in the RVID group were (1.24±0.26) ng/L and (25.46±3.72) ng/L, respectively, lower than those in the control group (all P < 0.05). When comparing with the mild RVID group, the strains of E. coli, Bifidobacterium, Lactobacillus, Clostridium and Bacteroides in the severe RVID group decreased; the level of miR-125b-1-3p in severe group was higher than that in mild group (P < 0.05), and Nrf2 and HO-1 in severe group were lower than those in mild group (all P < 0.05). Pearson correlation coefficient analysis showed that miR-125b-1-3p expression was positively correlated with Vesikari score of RVID children (P < 0.05), and Nrf2 and HO-1 levels were negatively correlated with Vesikari score in RVID children (P < 0.05).

CONCLUSIONS The strains of E. coli, Bifidobacterium, Lactobacillus, Clostridium and Bacteroides decrease in children with RVID. Elevated miR-125b-1-3p and reduced Nrf2 and HO-1 levels in peripheral blood are correlated with the severity of the disease.