Verwoerd Anouk, Ter Haar Nienke M, de Roock Sytze, Vastert Sebastiaan J, Bogaert Debby
Laboratory of Translational Immunology, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
Department of Paediatric Rheumatology, Wilhelmina Children's Hospital, Lundlaan 6, 3584 EA, Utrecht, The Netherlands.
Pediatr Rheumatol Online J. 2016 Sep 20;14(1):55. doi: 10.1186/s12969-016-0114-4.
Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in childhood. The pathogenesis of JIA is thought to be the result of a combination of host genetic and environmental triggers. However, the precise factors that determine one's susceptibility to JIA remain to be unravelled. The microbiome has received increasing attention as a potential contributing factor to the development of a wide array of immune-mediated diseases, including inflammatory bowel disease, type 1 diabetes and rheumatoid arthritis. Also in JIA, there is accumulating evidence that the composition of the microbiome is different from healthy individuals. A growing body of evidence indeed suggests that, among others, the microbiome may influence the development of the immune system, the integrity of the intestinal mucosal barrier, and the differentiation of T cell subsets. In turn, this might lead to dysregulation of the immune system, thereby possibly playing a role in the development of JIA. The potential to manipulate the microbiome, for example by faecal microbial transplantation, might then offer perspectives for future therapeutic interventions. Before we can think of such interventions, we need to first obtain a deeper understanding of the cause and effect relationship between JIA and the microbiome. In this review, we discuss the existing evidence for the involvement of the microbiome in JIA pathogenesis and explore the potential mechanisms through which the microbiome may influence the development of autoimmunity in general and JIA specifically.
幼年特发性关节炎（JIA）是儿童时期最常见的风湿性疾病。JIA的发病机制被认为是宿主遗传因素和环境触发因素共同作用的结果。然而，决定个体对JIA易感性的精确因素仍有待阐明。微生物群作为包括炎症性肠病、1型糖尿病和类风湿关节炎在内的多种免疫介导疾病发展的潜在促成因素，受到了越来越多的关注。在JIA中也有越来越多的证据表明，微生物群的组成与健康个体不同。越来越多的证据确实表明，微生物群可能会影响免疫系统的发育、肠道黏膜屏障的完整性以及T细胞亚群的分化等。反过来，这可能导致免疫系统失调，从而可能在JIA的发病过程中发挥作用。例如，通过粪便微生物移植来操纵微生物群的可能性，可能为未来的治疗干预提供思路。在我们考虑此类干预措施之前，我们首先需要更深入地了解JIA与微生物群之间的因果关系。在这篇综述中，我们讨论了微生物群参与JIA发病机制的现有证据，并探讨了微生物群可能影响自身免疫性疾病特别是JIA发展的潜在机制。
