Department of Rheumatology and Immunology, The Second Affiliated Hospital of Hainan Medical University, Haikou, China.
Nanjing Medical University, Nanjing, China.
Front Immunol. 2024 Nov 4;15:1475528. doi: 10.3389/fimmu.2024.1475528. eCollection 2024.
Systemic sclerosis (SSc) is a rare and highly heterogeneous chronic autoimmune disease characterized by multi-organ and tissue fibrosis, often accompanied by a poor prognosis and high mortality rates. The primary pathogenic mechanisms of SSc are considered to involve tissue fibrosis, autoimmune dysfunction, and microvascular abnormalities. Recent studies have shed light on the gut microbiota (GM) and metabolites in SSc patients, revealing their association with gastrointestinal symptoms and disease phenotypes. However, further elucidation is needed on the specific mechanisms underlying the interactions between GM, metabolites, and the immune system and their roles in the pathogenesis of SSc. This review outlines the characteristics of GM and metabolites in SSc patients, exploring their interrelationships and analyzing their correlations with the clinical phenotypes of SSc. The findings indicate that while the α-diversity of GM in SSc patients resembles that of healthy individuals, notable differences exist in the β-diversity and the abundance of specific bacterial genera, which are closely linked to gastrointestinal symptoms. Moreover, alterations in the levels of amino acids and lipid metabolites in SSc patients are prominently observed and significantly associated with clinical phenotypes. Furthermore, this review delves into the potential immunopathological mechanisms of GM and metabolites in SSc, emphasizing the critical role of interactions between GM, metabolites, and the immune system in comprehending the immunopathological processes of SSc. These insights may offer new scientific evidence for the development of future treatment strategies.
系统性硬化症（SSc）是一种罕见且高度异质性的慢性自身免疫性疾病，其特征为多器官和组织纤维化，常伴有不良预后和高死亡率。SSc 的主要发病机制被认为涉及组织纤维化、自身免疫功能障碍和微血管异常。最近的研究揭示了肠道微生物群（GM）和 SSc 患者代谢物的特征，它们与胃肠道症状和疾病表型有关。然而，GM、代谢物与免疫系统之间的相互作用的具体机制及其在 SSc 发病机制中的作用仍需进一步阐明。本综述概述了 SSc 患者 GM 和代谢物的特征，探讨了它们之间的相互关系，并分析了它们与 SSc 临床表型的相关性。研究结果表明，尽管 SSc 患者 GM 的 α-多样性与健康个体相似，但β-多样性和特定细菌属的丰度存在显著差异，这些差异与胃肠道症状密切相关。此外，还明显观察到 SSc 患者氨基酸和脂质代谢物水平的改变，且这些改变与临床表型显著相关。此外，本综述深入探讨了 GM 和代谢物在 SSc 中的潜在免疫病理机制，强调了 GM、代谢物和免疫系统之间的相互作用在理解 SSc 免疫病理过程中的关键作用。这些见解可能为未来治疗策略的发展提供新的科学依据。
