探讨肠道微生物在脊柱关节炎中的作用:对发病机制和治疗策略的影响。

Exploring the role of gut microbes in spondyloarthritis: Implications for pathogenesis and therapeutic strategies.

机构信息

School of Medicine, Oregon Health and Science University, Portland, OR, 97239, USA.

Division of Arthritis and Rheumatic Diseases, Oregon Health and Science University, Portland, OR, 97239, USA.

出版信息

Best Pract Res Clin Rheumatol. 2024 May;38(2):101961. doi: 10.1016/j.berh.2024.101961. Epub 2024 Jun 8.

Abstract

The gut microbiota plays a pivotal role in regulating host immunity, and dysregulation of this interaction is implicated in autoimmune and inflammatory diseases, including spondyloarthritis (SpA). This review explores microbial dysbiosis and altered metabolic function observed in various forms of SpA, such as ankylosing spondylitis (AS), psoriatic arthritis (PsA), acute anterior uveitis (AAU), and SpA-associated gut inflammation. Studies on animal models and clinical samples highlight the association between gut microbial dysbiosis, metabolic perturbations and immune dysregulation in SpA pathogenesis. These studies have received impetus through next-generation sequencing methods, which have enabled the characterization of gut microbial composition and function, and host gene expression. Microbial/metabolomic studies have revealed potential biomarkers and therapeutic targets, such as short-chain fatty acids, and tryptophan metabolites, offering insights into disease mechanisms and treatment approaches. Further studies on microbial function and its modulation of the immune response have uncovered molecular mechanisms underlying various SpA. Understanding the complex interplay between microbial community structure and function holds promise for improved diagnosis and management of SpA and other autoimmune disorders.

摘要

肠道微生物群在调节宿主免疫中起着关键作用,这种相互作用的失调与自身免疫和炎症性疾病有关,包括脊柱关节炎(SpA)。这篇综述探讨了各种形式的 SpA 中观察到的微生物失调和代谢功能改变,如强直性脊柱炎(AS)、银屑病关节炎(PsA)、急性前葡萄膜炎(AAU)和与 SpA 相关的肠道炎症。动物模型和临床样本的研究强调了肠道微生物失调、代谢紊乱和 SpA 发病机制中的免疫失调之间的关联。这些研究通过下一代测序方法得到了推动,这些方法使肠道微生物组成和功能以及宿主基因表达的特征成为可能。微生物/代谢组学研究揭示了潜在的生物标志物和治疗靶点,如短链脂肪酸和色氨酸代谢物,为疾病机制和治疗方法提供了新的见解。对微生物功能及其对免疫反应的调节的进一步研究揭示了各种 SpA 的分子机制。了解微生物群落结构和功能之间的复杂相互作用有望改善 SpA 和其他自身免疫性疾病的诊断和治疗。

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