Cai Xiaoyu, Ren Fujia, Yao Yao
Department of Pharmacy Hangzhou First People's Hospital Hangzhou China.
Department of Pharmacy Hangzhou Women's Hospital Hangzhou China.
Int Immunopharmacol. 2025 Feb 6;147:114034. doi: 10.1016/j.intimp.2025.114034. Epub 2025 Jan 12.
Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by persistent joint inflammation, damage, and loss of function. In recent years, the role of gut microbiota and its metabolites in immune regulation has attracted increasing attention. The gut microbiota influences the host immune system's homeostasis through various mechanisms, regulating the differentiation, function, and immune tolerance of immune cells. Dysbiosis of the gut microbiota in RA patients is closely associated with abnormal activation of immune cells and excessive secretion of inflammatory cytokines. Metabolites produced by the gut microbiota, such as short-chain fatty acids (SCFAs), tryptophan metabolites, bile acids, and amino acid metabolites, play a critical role in immune responses, regulating the functions of immune cells like T cells, B cells, and macrophages, and inhibiting the release of pro-inflammatory cytokines. Restoring the balance of the gut microbiota and optimizing the production of metabolic products may become a new strategy for RA treatment. This review discusses the role of gut microbiota and its metabolites in the immune response of RA, exploring how they influence the immunopathological process of RA through the regulation of immune cells and key immune factors. It also provides a theoretical basis for future therapeutic strategies based on gut microbiota modulation.
类风湿性关节炎（RA）是一种慢性自身免疫性疾病，其特征为持续的关节炎症、损伤和功能丧失。近年来，肠道微生物群及其代谢产物在免疫调节中的作用受到越来越多的关注。肠道微生物群通过多种机制影响宿主免疫系统的稳态，调节免疫细胞的分化、功能和免疫耐受。RA患者肠道微生物群的失调与免疫细胞的异常激活和炎性细胞因子的过度分泌密切相关。肠道微生物群产生的代谢产物，如短链脂肪酸（SCFAs）、色氨酸代谢产物、胆汁酸和氨基酸代谢产物，在免疫反应中起关键作用，调节T细胞、B细胞和巨噬细胞等免疫细胞的功能，并抑制促炎细胞因子的释放。恢复肠道微生物群的平衡并优化代谢产物的产生可能成为RA治疗的新策略。本文综述讨论了肠道微生物群及其代谢产物在RA免疫反应中的作用，探讨它们如何通过调节免疫细胞和关键免疫因子影响RA的免疫病理过程。它还为未来基于肠道微生物群调节的治疗策略提供了理论基础。
