Stoll Matthew L, Cron Randy Q
Division of Rheumatology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Curr Opin Rheumatol. 2016 Sep;28(5):537-43. doi: 10.1097/BOR.0000000000000312.
There has been increasing interest in the contents and function of the microbiota, as it relates to pediatric inflammatory diseases. Here, we discuss the factors underlying the development of the microbiota, its role in juvenile idiopathic arthritis (JIA) and prospects for therapeutic interventions in the microbiota.
The human microbiota undergoes a succession of changes, until it reaches a mature form. A variety of early-life exposures, including mode of delivery and form of feeding, can affect the contents of the microbiota and possibly impact upon long-term risk of developing autoimmune diseases. The microbiota is altered in children with JIA, including elevated Bacteroides genus in JIA as a whole and decreased Faecalibacterium prausnitzii in pediatric spondyloarthritis. Although there are limited data so far indicating that microbiota-based therapies can result in therapeutic improvement of arthritis, most of the data are on adults and thus may not be applicable to children.
Perturbations of the microbiota during childhood may result in the development of a microbiota associated with increased risk of pediatric rheumatic illness. Whether the microbiota can be targeted is a focus of ongoing research.
人们对微生物群的成分和功能越来越感兴趣，因为它与儿科炎症性疾病有关。在此，我们讨论微生物群发育的潜在因素、其在幼年特发性关节炎（JIA）中的作用以及微生物群治疗干预的前景。
人类微生物群会经历一系列变化，直至达到成熟形式。多种早期生活暴露因素，包括分娩方式和喂养方式，可影响微生物群的成分，并可能影响自身免疫性疾病的长期发病风险。JIA患儿的微生物群发生改变，包括JIA总体上拟杆菌属升高，以及小儿脊柱关节炎中普拉梭菌减少。尽管目前仅有有限的数据表明基于微生物群的疗法可改善关节炎，但大多数数据来自成人，因此可能不适用于儿童。
儿童期微生物群的扰动可能导致与小儿风湿性疾病风险增加相关的微生物群的形成。微生物群是否可作为治疗靶点是正在进行的研究重点。
