Department of Medicine, University of California, Los Angeles, David Geffen School of Medicine.
Department of Medicine, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
Curr Opin Rheumatol. 2024 Nov 1;36(6):401-409. doi: 10.1097/BOR.0000000000001048. Epub 2024 Aug 23.
This review highlights the role of the gastrointestinal (GI) microbiome in systemic sclerosis (SSc). We describe techniques for evaluating the GI microbiome in humans, and emerging research linking GI microbiome alterations (i.e., dysbiosis) and distinct SSc clinical manifestations. We also address the evolving treatment landscape targeting dysbiosis in SSc.
Recent literature brings into focus the complex relationship between the GI microbiome and SSc pathogenesis. Advanced techniques (e.g., shotgun metagenomics, meta-transcriptomics) provide deeper insights into microbial taxonomy and active gene expression, exposing dysbiosis as a potential driver of SSc. New studies demonstrate that SSc patients who possess specific SSc clinical features, (e.g., interstitial lung disease), have unique GI microbiome profiles.
Dysbiosis is associated with specific clinical features in patients with SSc. New tools for studying the GI microbiome have furthered our understanding of the relationship between dysbiosis and SSc complications. Therapeutic avenues such as dietary adjustments, probiotics, antibiotics, mindfulness practices, and fecal transplants offer potential for managing SSc and preventing its progression through GI microbiome modulation. By clarifying what is known about the relationship between the GI dysbiosis, GI dysfunction, and SSc, this review enhances our understanding of SSc pathogenesis and proposes targeted interventions.
本综述强调了胃肠道（GI）微生物组在系统性硬化症（SSc）中的作用。我们描述了评估人类 GI 微生物组的技术，以及将 GI 微生物组改变（即，生态失调）与不同的 SSc 临床表现联系起来的新兴研究。我们还探讨了针对 SSc 生态失调的不断发展的治疗领域。
最近的文献强调了 GI 微生物组与 SSc 发病机制之间的复杂关系。先进的技术（例如，鸟枪法宏基因组学、meta 转录组学）提供了对微生物分类和活跃基因表达的更深入了解，揭示了生态失调是 SSc 的潜在驱动因素。新的研究表明，具有特定 SSc 临床特征（例如，间质性肺病）的 SSc 患者具有独特的 GI 微生物组谱。
生态失调与 SSc 患者的特定临床特征有关。研究 GI 微生物组的新工具进一步加深了我们对生态失调与 SSc 并发症之间关系的理解。治疗途径，如饮食调整、益生菌、抗生素、正念练习和粪便移植，为通过 GI 微生物组调节来管理 SSc 和预防其进展提供了潜力。通过阐明 GI 生态失调、GI 功能障碍与 SSc 之间的关系，本综述增强了我们对 SSc 发病机制的理解，并提出了有针对性的干预措施。
