Identification of the Alterations of Gut Microbiome and Its Relationship with NF-κB in Patients with Type 2 Diabetes and Diabetic Peripheral Neuropathy

The surge in diabetic peripheral neuropathy (DPN) cases in recent years has underscored the urgent need for more intensive research into its prevention and management. The nuclear factor (NF)-κB is recognized as a key mediator in the development of diabetic microvascular complications, with alterations in gut microbiota dynamics being a significant factor in triggering NF-κB. Therefore, we proposed that there is a relationship among DPN, NF-κB, and gut microbiota. We conducted 16S rRNA sequencing to analyze the gut microbiota of individuals with DPN and type 2 diabetes (T2DM), and healthy controls, while also measured NF-κB levels. Our research findings indicate significant differences in the microbial composition among the three groups, particularly at the phylum level, with the control group showing a higher abundance of Firmicutes and a lower abundance of Bacteroidetes compared to the other two groups. Additionally, the α and β diversity were significantly lower in T2DM and DPN patients. Furthermore, a strong correlation was observed, indicating that the Clostridiales and Trichospirillaceae were significantly associated with levels of TG, FPG, and HDL-C. Moreover, specific gut bacteria, such as Coccosia, Barnesiella, and Roseburia, demonstrated robust associations with NF-κB level, suggesting the potential role in the pathophys-iology of DPN. Individuals afflicted with T2DM and DPN present with pro-nounced dysbiosis of the gut microbiota. This gut microbiota exhibits signifi-cant correlations with key physiological markers and clinical manifestations within the affected individuals, suggesting that these microbial shifts are inte-gral to the pathogenesis and progression of diabetic complications.