Department of Ophthalmology, College of Medicine, Seoul National University, Seoul 03080, Korea.
Seoul Artificial Eye Center, Laboratory of Ocular Regenerative Medicine and Immunology, Seoul National University Hospital Biomedical Research Institute, Seoul 03082, Korea.
Int J Mol Sci. 2020 Nov 10;21(22):8443. doi: 10.3390/ijms21228443.
Using metagenomics, continuing evidence has elicited how intestinal microbiota trigger distant autoimmunity. Sjögren's syndrome (SS) is an autoimmune disease that affects the ocular surface, with frequently unmet therapeutic needs requiring new interventions for dry eye management. Current studies also suggest the possible relation of autoimmune dry eye with gut microbiota. Herein, we review the current knowledge of how the gut microbiota interact with the immune system in homeostasis as well as its influence on rheumatic and ocular autoimmune diseases, and compare their characteristics with SS. Both rodent and human studies regarding gut microbiota in SS and environmental dry eye are explored, and the effects of prebiotics and probiotics on dry eye are discussed. Recent clinical studies have commonly observed a correlation between gut dysbiosis and clinical manifestations of SS, while environmental dry eye portrays characteristics in between normal and autoimmune. Moreover, a decrease in both the / ratio and genus have most commonly been observed in SS subjects. The presumable pathways forming the "gut dysbiosis-ocular surface-lacrimal gland axis" are introduced. This review may provide perspectives into the link between the gut microbiome and dry eye, enhance our understanding of the pathogenesis in autoimmune dry eye, and be useful in the development of future interventions.
利用宏基因组学，越来越多的证据表明肠道微生物群如何引发远处的自身免疫。干燥综合征（SS）是一种影响眼表的自身免疫性疾病，经常存在未满足的治疗需求，需要新的干预措施来管理干眼症。目前的研究还表明，自身免疫性干眼症与肠道微生物群可能有关。在此，我们回顾了肠道微生物群在稳态下与免疫系统相互作用及其对风湿和眼部自身免疫性疾病的影响的现有知识，并将其与 SS 进行了比较。探讨了 SS 和环境性干眼症中肠道微生物群的啮齿动物和人体研究，并讨论了益生元和益生菌对干眼症的影响。最近的临床研究普遍观察到 SS 患者的肠道菌群失调与临床表现之间存在相关性，而环境性干眼症则介于正常和自身免疫性之间。此外，SS 患者中最常见的是 / 比值和属的减少。介绍了形成“肠道菌群失调-眼表-泪腺轴”的可能途径。本综述可能为肠道微生物群与干眼症之间的联系提供新视角，加深我们对自身免疫性干眼症发病机制的理解，并有助于未来干预措施的发展。
