Jin Jiayang, Cai Xuanlin, Rao Peishi, Xu Jun, Li Jing
Department of Rheumatology and Immunology, Peking University People's Hospital, No. 11, Xizhimen South Street, Xicheng District, Beijing, 100044, China; Beijing Key Laboratory for Rheumatism Mechanism and Immune Diagnosis (BZ0135), No. 11, Xizhimen South Street, Xicheng District, Beijing, 100044, China.
Department of Gastroenterology, Peking University People's Hospital, No. 11, Xizhimen South Street, Xicheng District, Beijing, 100044, China; Clinical Center of Immune-Mediated Digestive Diseases, Peking University People's Hospital, No. 11, Xizhimen South Street, Xicheng District, Beijing, 100044, China.
Best Pract Res Clin Rheumatol. 2025 Mar;39(1):102035. doi: 10.1016/j.berh.2025.102035. Epub 2025 Jan 25.
Rheumatoid arthritis (RA) is a complex autoimmune disease with growing evidence implicating the microbiota as a critical contributor to its pathogenesis. This review explores the multifaceted roles of microbial dysbiosis in RA, emphasizing its impact on immune cell modulation, autoantibody production, gut barrier integrity, and joint inflammation. Animal models reveal how genetic predisposition and environmental factors interact with specific microbial taxa to influence disease susceptibility. Dysbiosis-driven metabolic disruptions, including alterations in short-chain fatty acids and bile acids, further exacerbate immune dysregulation and systemic inflammation. Emerging therapeutic strategies-probiotics, microbial metabolites, fecal microbiota transplantation, and antibiotics-offer innovative avenues for restoring microbial balance and mitigating disease progression. By integrating microbiota-targeted approaches with existing treatments, this review highlights the potential to revolutionize RA management through precision medicine and underscores the need for further research to harness the microbiota's therapeutic potential.
类风湿性关节炎（RA）是一种复杂的自身免疫性疾病，越来越多的证据表明微生物群是其发病机制的关键促成因素。本综述探讨了微生物群失调在类风湿性关节炎中的多方面作用，强调了其对免疫细胞调节、自身抗体产生、肠道屏障完整性和关节炎症的影响。动物模型揭示了遗传易感性和环境因素如何与特定的微生物分类群相互作用以影响疾病易感性。由微生物群失调驱动的代谢紊乱，包括短链脂肪酸和胆汁酸的改变，进一步加剧了免疫失调和全身炎症。新兴的治疗策略——益生菌、微生物代谢产物、粪便微生物群移植和抗生素——为恢复微生物平衡和减轻疾病进展提供了创新途径。通过将针对微生物群的方法与现有治疗方法相结合，本综述强调了通过精准医学彻底改变类风湿性关节炎管理的潜力，并强调了进一步研究以利用微生物群治疗潜力的必要性。
