Ge Yuanxin, Yang Huifang, Fu Yang, Zhou Jie, Cheng Zilin, Fan Xiaohong, Yu Yang
Sichuan Provincial Hospital of Traditional Chinese Medicine, Chengdu, China.
Department of Rehabilitation, Chongqing Traditional Chinese Medicine Hospital, Chongqing, China.
Eur Spine J. 2025 Mar 19. doi: 10.1007/s00586-025-08795-z.
Emerging evidence suggests a link between gut microbiota and intervertebral disc diseases (IDDs); however, the causal relationships remain unclear. This study aimed to evaluate the causal effects of gut microbiota on the risk of cervical disc disorders (CDD), other intervertebral disc disorders (OIDD), pyogenic intervertebral disc infections, and discitis, shedding light on the potential "gut-disc axis".
Genetic variation data for 202 gut microbiota taxa were obtained from the Dutch Microbiome Project, and disease outcome data were sourced from the FinnGen consortium. A Mendelian Randomization (MR) approach was employed to assess causal relationships, using genetic variants as instrumental variables. Sensitivity analyses, including tests for pleiotropy, heterogeneity, and reverse causation, ensured robust findings.
The study identified 20 gut microbial taxa with significant associations to IDDs. Notably, taxa within the Erysipelotrichaceae family showed consistent protective effects against OIDD after Bonferroni correction (P < 0.05). Associations between several species and specific diseases, such as Alistipes senegalensis with CDD and Ruminococcus lactaris with discitis, were also observed. Sensitivity analyses confirmed no evidence of confounding or reverse causation.
This study provides evidence of causal relationships between specific gut microbiota and IDDs, supporting the existence of a "gut-disc axis." The findings suggest that microbial dysbiosis may influence spinal health through systemic inflammation and immune regulation. These insights open new possibilities for microbiota-targeted interventions, such as probiotics or dietary modifications, to prevent or manage IDDs. However, further research is required to validate these therapeutic strategies.
新出现的证据表明肠道微生物群与椎间盘疾病（IDD）之间存在联系；然而，因果关系仍不明确。本研究旨在评估肠道微生物群对颈椎间盘疾病（CDD）、其他椎间盘疾病（OIDD）、化脓性椎间盘感染和椎间盘炎风险的因果影响，以阐明潜在的“肠 - 椎间盘轴”。
从荷兰微生物组计划获得202种肠道微生物分类群的基因变异数据，疾病结局数据来自芬兰基因组联盟。采用孟德尔随机化（MR）方法，以基因变异作为工具变量来评估因果关系。敏感性分析，包括多效性、异质性和反向因果关系检验，确保了研究结果的稳健性。
该研究确定了20种与IDD有显著关联的肠道微生物分类群。值得注意的是，在经Bonferroni校正后，丹毒丝菌科内的分类群对OIDD显示出一致的保护作用（P < 0.05）。还观察到几种物种与特定疾病之间的关联，如塞内加尔阿里斯杆菌与CDD以及乳酸瘤胃球菌与椎间盘炎。敏感性分析证实没有混杂或反向因果关系的证据。
本研究提供了特定肠道微生物群与IDD之间因果关系的证据，支持了“肠 - 椎间盘轴”的存在。研究结果表明，微生物失调可能通过全身炎症和免疫调节影响脊柱健康。这些见解为以微生物群为靶点的干预措施，如益生菌或饮食调整，预防或管理IDD开辟了新的可能性。然而，需要进一步研究来验证这些治疗策略。
