Heilongjiang Beidahuang Group General Hospital, Heilongjiang, China.
Department of Pharmacy, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
APMIS. 2024 Jun;132(6):382-415. doi: 10.1111/apm.13401. Epub 2024 Mar 12.
Rheumatoid arthritis (RA) is a multifaceted autoimmune disorder characterized by chronic inflammation and joint destruction. Recent research has elucidated the intricate interplay between gut microbiota and RA pathogenesis, underscoring the role of microbiota-derived metabolites as pivotal contributors to disease development and progression. The human gut microbiota, comprising a vast array of microorganisms and their metabolic byproducts, plays a crucial role in maintaining immune homeostasis. Dysbiosis of this microbial community has been linked to numerous autoimmune disorders, including RA. Microbiota-derived metabolites, such as short-chain fatty acids (SCFAs), tryptophan derivatives, Trimethylamine-N-oxide (TMAO), bile acids, peptidoglycan, and lipopolysaccharide (LPS), exhibit immunomodulatory properties that can either exacerbate or ameliorate inflammation in RA. Mechanistically, these metabolites influence immune cell differentiation, cytokine production, and gut barrier integrity, collectively shaping the autoimmune milieu. This review highlights recent advances in understanding the intricate crosstalk between microbiota metabolites and RA pathogenesis and also discusses the potential of specific metabolites to trigger or suppress autoimmunity, shedding light on their molecular interactions with immune cells and signaling pathways. Additionally, this review explores the translational aspects of microbiota metabolites as diagnostic and prognostic tools in RA. Furthermore, the challenges and prospects of translating these findings into clinical practice are critically examined.
类风湿关节炎(RA)是一种多方面的自身免疫性疾病,其特征为慢性炎症和关节破坏。最近的研究阐明了肠道微生物群与 RA 发病机制之间的复杂相互作用,强调了微生物衍生代谢物作为疾病发展和进展的关键因素的作用。人类肠道微生物群由大量的微生物及其代谢产物组成,在维持免疫稳态方面起着至关重要的作用。这种微生物群落的失调与许多自身免疫性疾病有关,包括 RA。微生物衍生代谢物,如短链脂肪酸(SCFAs)、色氨酸衍生物、氧化三甲胺(TMAO)、胆汁酸、肽聚糖和脂多糖(LPS),具有免疫调节特性,可以加剧或减轻 RA 中的炎症。从机制上讲,这些代谢物影响免疫细胞分化、细胞因子产生和肠道屏障完整性,共同塑造自身免疫环境。这篇综述强调了对微生物群代谢物与 RA 发病机制之间复杂相互作用的最新理解,并讨论了特定代谢物引发或抑制自身免疫的潜力,揭示了它们与免疫细胞和信号通路的分子相互作用。此外,本综述还探讨了微生物群代谢物作为 RA 诊断和预后工具的转化方面。此外,还批判性地检查了将这些发现转化为临床实践的挑战和前景。