Arvonen Miika, Berntson Lillemor, Pokka Tytti, Karttunen Tuomo J, Vähäsalo Paula, Stoll Matthew L
Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland.
Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.
Pediatr Rheumatol Online J. 2016 Jul 22;14(1):44. doi: 10.1186/s12969-016-0104-6.
Juvenile idiopathic arthritis is the most common form of chronic arthritis in children. There is mounting evidence that the microbiota may influence the disease.
Recent observations in several systemic inflammatory diseases including JIA have indicated that abnormalities in the contents of the microbiota may be factors in disease pathogenesis, while other studies in turn have shown that environmental factors impacting the composition of the microbiota, such as delivery mode and early exposure to antibiotics, affect the risk of chronic inflammatory diseases including JIA. Microbial alterations may predispose to JIA through a variety of mechanisms, including impaired immunologic development, alterations in the balances of pro- versus anti-inflammatory bacteria, and low-grade mucosal inflammation. Additional confirmatory studies of microbiota aberrations and their risk factors are needed, as well as additional mechanistic studies linking these alterations to the disease itself.
The microbiota may influence the risk of JIA and other systemic inflammatory conditions through a variety of mechanisms. Additional research is required to improve our understanding of the links between the microbiota and arthritis, and the treatment implications thereof.
幼年特发性关节炎是儿童慢性关节炎最常见的形式。越来越多的证据表明微生物群可能会影响这种疾病。
最近在包括幼年特发性关节炎在内的几种全身性炎症性疾病中的观察表明，微生物群内容物的异常可能是疾病发病机制中的因素，而其他研究则表明，影响微生物群组成的环境因素，如分娩方式和早期接触抗生素，会影响包括幼年特发性关节炎在内的慢性炎症性疾病的风险。微生物改变可能通过多种机制使个体易患幼年特发性关节炎，包括免疫发育受损、促炎菌与抗炎菌平衡的改变以及低度黏膜炎症。需要对微生物群异常及其风险因素进行更多的验证性研究，以及将这些改变与疾病本身联系起来的更多机制研究。
微生物群可能通过多种机制影响幼年特发性关节炎和其他全身性炎症性疾病的风险。需要进行更多研究，以增进我们对微生物群与关节炎之间联系及其治疗意义的理解。
