Gilis Elisabeth, Mortier Céline, Venken Koen, Debusschere Karlijn, Vereecke Lars, Elewaut Dirk
From the Laboratory for Molecular Immunology and Inflammation, Department of Rheumatology, University Hospital Ghent; the Vlaams Instituut voor Biotechnologie (VIB) Center for Inflammation Research (IRC), Ghent, Belgium.
E. Gilis, MSc, Laboratory for Molecular Immunology and Inflammation, Department of Rheumatology, University Hospital Ghent, and VIB IRC; C. Mortier, DVM, Laboratory for Molecular Immunology and Inflammation, Department of Rheumatology, University Hospital Ghent, and VIB IRC; K. Venken, PhD, Laboratory for Molecular Immunology and Inflammation, Department of Rheumatology, University Hospital Ghent, and VIB IRC; K. Debusschere, DVM, Laboratory for Molecular Immunology and Inflammation, Department of Rheumatology, University Hospital Ghent, and VIB IRC; L. Vereecke, PhD, Laboratory for Molecular Immunology and Inflammation, Department of Rheumatology, University Hospital Ghent, and VIB IRC; D. Elewaut, MD, PhD, Professor, Laboratory for Molecular Immunology and Inflammation, Department of Rheumatology, University Hospital Ghent, and VIB IRC.
J Rheumatol Suppl. 2018 Jun;94:36-39. doi: 10.3899/jrheum.180135.
Spondyloarthritis (SpA) encompasses a group of diseases characterized by an inflammatory arthritis involving both joints and entheses. However, extraarticular symptoms constitute a large element of the pathology and should not be underestimated. Microscopic gut inflammation is observed in 50% of patients with SpA and has been linked to disease activity, underscoring the effect of gut inflammation in SpA. In this review, we discuss the influence of gut microbiota on SpA pathogenesis. A change in microbiota composition has been linked to the development of various inflammatory arthritides, and dysbiosis is a potential factor in the pathogenesis of multiple inflammatory diseases. In this context, several groups have reported the modulatory effects of gut microbiota-derived metabolites on the effect of immune cells. The gut mucosa is populated by several types of regulatory T cells, but also some specialized unconventional innate-like T cells. These cells are predominantly found at mucosal and epithelial barrier sites, where they serve an essential role in modulating host-microbial interplay. Apart from the close association between the composition of the microbiota and inflammatory diseases, the therapeutic value of dysbiosis needs further investigation, and the identification of a causal inflammatory pathway between gut dysbiosis and musculoskeletal inflammation could revolutionize the therapeutic approach in SpA.
脊柱关节炎（SpA）包括一组以累及关节和附着点的炎性关节炎为特征的疾病。然而，关节外症状是病理的重要组成部分，不应被低估。50%的SpA患者存在微观肠道炎症，且其与疾病活动相关，这突出了肠道炎症在SpA中的作用。在本综述中，我们讨论肠道微生物群对SpA发病机制的影响。微生物群组成的改变与各种炎性关节炎的发生有关，生态失调是多种炎性疾病发病机制中的一个潜在因素。在此背景下，多个研究小组报道了肠道微生物群衍生代谢产物对免疫细胞作用的调节效应。肠道黏膜中有几种调节性T细胞，也有一些特殊的非常规固有样T细胞。这些细胞主要存在于黏膜和上皮屏障部位，在调节宿主与微生物的相互作用中发挥重要作用。除了微生物群组成与炎性疾病之间的密切关联外，生态失调的治疗价值还需要进一步研究，确定肠道生态失调与肌肉骨骼炎症之间的因果炎性途径可能会彻底改变SpA的治疗方法。
