Yao Yao, Cai Xiaoyu, Fei Weidong, Ren Fujia, Wang Fengmei, Luan Xiaofei, Chen Fengying, Zheng Caihong
Department of Pharmacy, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Department of Pharmacy, Hangzhou First People's Hospital, Hangzhou, China.
Front Pharmacol. 2020 Nov 11;11:594042. doi: 10.3389/fphar.2020.594042. eCollection 2020.
Rheumatoid arthritis (RA) is an autoimmune disease characterized by synovial inflammation and bone destruction. Microbial infection is considered to be the most important inducement of RA. The pregnancy planning of women in childbearing age is seriously affected by the disease activity of RA. Gut microbiome, related to immunity and inflammatory response of the host. At present, emerging evidence suggested there are significant differences in the diversity and abundance of gut microbiome during pregnancy and lactation, which may be associated with the fluctuation of RA disease activity. Based on these research foundations, we pioneer the idea of regulating gut microbiome for the treatment of RA during pregnancy and lactation. In this review, we mainly introduce the potential treatment strategies for controlling the disease activity of RA based on gut microbiome during pregnancy and lactation. Besides, we also briefly generalize the effects of conventional anti-rheumatic drugs on gut microbiome, the effects of metabolic changes during pregnancy on gut microbiome, alteration of gut microbiome during pregnancy and lactation, and the effects of anti-rheumatic drugs commonly used during pregnancy and lactation on gut microbiome. These will provide a clear knowledge framework for researchers in immune-related diseases during pregnancy. Regulating gut microbiome may be a potential and effective treatment to control the disease activity of RA during pregnancy and lactation.
类风湿关节炎（RA）是一种以滑膜炎症和骨质破坏为特征的自身免疫性疾病。微生物感染被认为是RA最重要的诱因。育龄期女性的妊娠计划受到RA疾病活动的严重影响。肠道微生物群与宿主的免疫和炎症反应相关。目前，新出现的证据表明，妊娠和哺乳期肠道微生物群的多样性和丰度存在显著差异，这可能与RA疾病活动的波动有关。基于这些研究基础，我们率先提出在妊娠和哺乳期通过调节肠道微生物群来治疗RA的理念。在这篇综述中，我们主要介绍基于妊娠和哺乳期肠道微生物群控制RA疾病活动的潜在治疗策略。此外，我们还简要概括了传统抗风湿药物对肠道微生物群的影响、孕期代谢变化对肠道微生物群的影响、妊娠和哺乳期肠道微生物群的改变，以及妊娠和哺乳期常用抗风湿药物对肠道微生物群的影响。这些将为研究孕期免疫相关疾病的研究人员提供一个清晰的知识框架。调节肠道微生物群可能是控制妊娠和哺乳期RA疾病活动的一种潜在有效治疗方法。
