Department of Rheumatology & Immunology, Singapore General Hospital, Singapore City, Singapore.
Duke-NUS Medical School, Singapore City, Singapore.
Int J Rheum Dis. 2021 Aug;24(8):984-1003. doi: 10.1111/1756-185X.14123. Epub 2021 May 7.
Osteoarthritis (OA) is a common cause of disability, especially among the elderly. With an ageing and increasingly obese population, OA will become more prevalent. Obesity and metabolic syndrome are risk factors for OA and have been implicated in its pathogenesis. The gut microbiome may shed light on this possible common pathogenesis. Recent animal and human studies have gained important insights into the relationship between OA, obesity, and the gut microbiome. Animal studies have demonstrated links between obesity and increased severity of OA and altered gut microbial DNA profile. Use of prebiotics and probiotics in animal trials provides proof-of-concept that interventional options to the gut microbiome can modulate the progression of OA favorably. Current evidence in human studies is limited. Shifts in gut microbial profile and reduced gut microbial diversity have been associated with people with OA, as well as blood and synovial fluid lipopolysaccharide endotoxemia. Linkages between microbiome dysbiosis and host responses may help in the understanding of OA pathogenesis and the discovery of therapeutic targets. This narrative review provides a summary of up-to-date animal and human studies on the gut microbiome and its link with OA.
骨关节炎（OA）是一种常见的致残原因，尤其是在老年人中。随着人口老龄化和肥胖人口的增加，OA 的发病率将会更高。肥胖和代谢综合征是 OA 的危险因素，并与 OA 的发病机制有关。肠道微生物组可能为这种可能的共同发病机制提供线索。最近的动物和人体研究为 OA、肥胖和肠道微生物组之间的关系提供了重要的见解。动物研究表明，肥胖与 OA 严重程度的增加以及肠道微生物 DNA 图谱的改变有关。在动物试验中使用益生元和益生菌提供了概念验证，即肠道微生物组的干预措施可以有利地调节 OA 的进展。目前在人体研究中的证据有限。肠道微生物群谱的变化和肠道微生物多样性的减少与 OA 患者的血液和滑液内毒素血症有关。微生物失调与宿主反应之间的联系可能有助于理解 OA 的发病机制和发现治疗靶点。本综述提供了最新的关于肠道微生物组及其与 OA 关系的动物和人体研究的概述。
