Department of Rheumatology and Immunology, Tianjin Medical University General Hospital, Tianjin, China.
Discipline Construction Office, Tianjin Medical University, Tianjin, China.
Front Cell Infect Microbiol. 2022 Aug 22;12:973563. doi: 10.3389/fcimb.2022.973563. eCollection 2022.
As a set of inflammatory disorders, spondyloarthritis (SpA) exhibits distinct pathophysiological, clinical, radiological, and genetic characteristics. Due to the extra-articular features of this disorder, early recognition is crucial to limiting disability and improving outcomes. Gut dysbiosis has been linked to SpA development as evidence grows. A pathogenic SpA process is likely to occur when a mucosal immune system interacts with abnormal local microbiota, with subsequent joint involvement. It is largely unknown, however, how microbiota alterations predate the onset of SpA within the "gut-joint axis". New microbiome therapies, such as probiotics, are used as an adjuvant therapy in the treatment of SpA, suggesting that the modulation of intestinal microbiota and/or intestinal barrier function may contribute to the prevention of SpA. In this review, we highlight the mechanisms of SpA by which the gut microbiota impacts gut inflammation and triggers the activation of immune responses. Additionally, we analyze the regulatory role of therapeutic SpA medication in the gut microbiota and the potential application of probiotics as adjunctive therapy for SpA.
作为一组炎症性疾病，脊柱关节炎（SpA）表现出独特的病理生理学、临床、放射学和遗传学特征。由于该疾病的关节外特征，早期识别对于限制残疾和改善预后至关重要。越来越多的证据表明，肠道菌群失调与 SpA 的发展有关。当黏膜免疫系统与异常的局部微生物群相互作用，随后发生关节受累时，可能会发生致病的 SpA 过程。然而，在“肠道-关节轴”内，微生物群的改变如何先于 SpA 的发生，目前还知之甚少。新的微生物组疗法，如益生菌，被用作 SpA 的辅助治疗，这表明肠道微生物群的调节和/或肠道屏障功能的改变可能有助于预防 SpA。在这篇综述中，我们强调了肠道微生物群影响肠道炎症和触发免疫反应的机制，从而导致 SpA 的发生。此外，我们分析了治疗性 SpA 药物对肠道微生物群的调节作用，以及益生菌作为 SpA 辅助治疗的潜在应用。
