Sandhya Pulukool, Danda Debashish, Sharma Disha, Scaria Vinod
Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, Tamil Nadu, India.
GN Ramachandran Knowledge Center for Genome Informatics, CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Delhi, India.
Int J Rheum Dis. 2016 Jan;19(1):8-20. doi: 10.1111/1756-185X.12728. Epub 2015 Sep 19.
The human body is an environmental niche which is home to diverse co-habiting microbes collectively referred as the human microbiome. Recent years have seen the in-depth characterization of the human microbiome and associations with diseases. Linking of the composition or number of the human microbiota with diseases and traits date back to the original work of Elie Metchnikoff. Recent advances in genomic technologies have opened up finer details and dynamics of this new science with higher precision. Microbe-rheumatoid arthritis connection, largely related to the gut and oral microbiomes, has showed up as a result - apart from several other earlier, well-studied candidate autoimmune diseases. Although evidence favouring roles of specific microbial species, including Porphyromonas, Prevotella and Leptotricha, has become clearer, mechanistic insights still continue to be enigmatic. Manipulating the microbes by traditional dietary modifications, probiotics, and antibiotics and by currently employed disease-modifying agents seems to modulate the disease process and its progression. In the present review, we appraise the existing information as well as the gaps in knowledge in this challenging field. We also discuss the future directions for potential clinical applications, including prevention and management of rheumatoid arthritis using microbial modifications.
人体是一个环境生态位，是多种共同栖息的微生物的家园，这些微生物统称为人类微生物组。近年来，人们对人类微生物组进行了深入的表征，并研究了其与疾病的关联。将人类微生物群的组成或数量与疾病及特征联系起来的研究可以追溯到埃利·梅契尼科夫的开创性工作。基因组技术的最新进展使这一新兴科学的细节和动态得以更精确地展现。微生物与类风湿性关节炎的联系，很大程度上与肠道和口腔微生物组有关，这一联系已逐渐显现——除此之外，还有其他几种早期经过充分研究的候选自身免疫性疾病。尽管支持特定微生物物种（包括卟啉单胞菌、普氏菌和纤毛菌）发挥作用的证据越来越清晰，但其中的机制仍不明朗。通过传统的饮食调整、益生菌、抗生素以及目前使用的病情缓解药物来操控微生物，似乎可以调节疾病进程及其发展。在本综述中，我们评估了这一具有挑战性领域中的现有信息以及知识空白。我们还讨论了潜在临床应用的未来方向，包括通过微生物调控来预防和管理类风湿性关节炎。
