Faculty of Chemical-Biological Sciences, Autonomous University of Guerrero, Chilpancingo 39087, Mexico.
HLA Laboratory, National Institute of Respiratory Diseases Ismael Cosío Villegas, Mexico City 14080, Mexico.
Int J Mol Sci. 2023 Jan 19;24(3):1958. doi: 10.3390/ijms24031958.
Intestinal dysbiosis is related to the physiopathology and clinical manifestation of rheumatoid arthritis (RA) and the response to pharmacologic treatment. The objectives of this study were (1) to analyze the effect of conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs) on the abundance of gut microbiota's bacteria; (2) to evaluate the relationship between the differences in microbial abundance with the serum levels of intestinal fatty-acid binding protein 2 (IFABP2), cytokines, and the response phenotype to csDMARDs therapy in RA. A cross-sectional study was conducted on 23 women diagnosed with RA. The abundance of bacteria in gut microbiota was determined with qPCR. The ELISA technique determined serum levels of IFABP2, TNF-α, IL-10, and IL-17A. We found that the accumulated dose of methotrexate or prednisone is negatively associated with the abundance of but positively associated with the abundance of . The ratio was associated with the Disease Activity Score-28 for RA with Erythrocyte Sedimentation Rate (DAS28-ESR) (r = 0.778, = 0.030) and with the levels of IL-17A (r = 0.785, = 0.027) in the group treated with csDMARD. Moreover, a relation between the serum levels of IFABP2 and TNF-α (r = 0.593, = 0.035) was observed in the group treated with csDMARD. The serum levels of IFABP2 were higher in patients with secondary non-response to csDMARDs therapy. In conclusion, our results suggest that the ratios of gut microbiota's bacteria and intestinal permeability seems to establish the preamble for therapeutic secondary non-response in RA.
肠道菌群失调与类风湿关节炎（RA）的病理生理学和临床表现以及药物治疗反应有关。本研究的目的是：（1）分析常规合成的改善病情抗风湿药物（csDMARDs）对肠道微生物菌群细菌丰度的影响；（2）评估微生物丰度的差异与血清肠脂肪酸结合蛋白 2（IFABP2）、细胞因子水平以及对 csDMARDs 治疗反应的表型之间的关系。对 23 名诊断为 RA 的女性进行了横断面研究。采用 qPCR 检测肠道微生物菌群中细菌的丰度。采用 ELISA 技术测定血清 IFABP2、TNF-α、IL-10 和 IL-17A 水平。我们发现，累积剂量的甲氨蝶呤或泼尼松与 的丰度呈负相关，与 的丰度呈正相关。比值与红细胞沉降率的 RA 疾病活动评分-28（DAS28-ESR）（r = 0.778， = 0.030）和 csDMARD 治疗组的 IL-17A 水平（r = 0.785， = 0.027）相关。此外，csDMARD 治疗组还观察到 IFABP2 血清水平与 TNF-α（r = 0.593， = 0.035）之间存在相关性。csDMARD 治疗后发生继发性无反应的患者 IFABP2 血清水平较高。结论：我们的研究结果表明，肠道微生物菌群细菌的比值和肠道通透性似乎为 RA 治疗的继发性无反应奠定了基础。
