Wasim Rufaida, Ahmad Asad, Anwar Aamir, Salman Aimen
Department of Pharmacology, Faculty of Pharmacy, Integral University, Lucknow, UP, 226022, India.
Career Post Graduate Institute of Dental Sciences and Hospital, Lucknow, India.
Inflammopharmacology. 2025 Apr 12. doi: 10.1007/s10787-025-01737-7.
A chronic autoimmune illness that causes joint destruction and inflammation, rheumatoid arthritis (RA) often results in disability. Genetic, environmental, and immune system variables all have a role in the pathophysiology of RA. The complex community of bacteria that live in the gastrointestinal system, known as the gut microbiota, has been implicated in the onset and progression of RA in recent years, according to mounting data. An imbalance in the gut microbiota's composition, known as dysbiosis, has been noted in RA patients. This imbalance may impact inflammatory pathways and immunological responses, which in turn may contribute to the development and severity of the illness. Research has shown that some bacterial species, including Firmicutes, Bacteroidetes, and Proteobacteria, are either more abundant or less prevalent in RA patients than in healthy people. The gut-immune system axis may be modulated, immunological tolerance may be affected, and pro-inflammatory cytokine production may be enhanced by these microbial changes, all of which may lead to systemic inflammation linked to RA. Moreover, changes in intestinal permeability and a rise in microbial metabolite translocation may make autoimmune reactions worse. Probiotics, antibiotics, and dietary changes have also been investigated as possible treatment approaches to help RA patients regain the balance of their gut microbiota. Still up for debate, however, are the precise ways in which the gut microbiome affects RA. Comprehending the complex connection between gut microbiota and RA may give new perspectives on managing and preventing the condition, as well as future prospects for medicines that target the microbiome.
类风湿性关节炎(RA)是一种导致关节破坏和炎症的慢性自身免疫性疾病,常导致残疾。遗传、环境和免疫系统变量在RA的病理生理学中均起作用。近年来,越来越多的数据表明,存在于胃肠道系统中的复杂细菌群落,即肠道微生物群,与RA的发病和进展有关。RA患者中已发现肠道微生物群组成失衡,即生态失调。这种失衡可能影响炎症途径和免疫反应,进而可能导致疾病的发展和严重程度。研究表明,包括厚壁菌门、拟杆菌门和变形菌门在内的一些细菌种类在RA患者中比在健康人中更为丰富或更为少见。这些微生物变化可能调节肠道-免疫系统轴、影响免疫耐受性并增强促炎细胞因子的产生,所有这些都可能导致与RA相关的全身炎症。此外,肠道通透性的变化和微生物代谢产物转运的增加可能会使自身免疫反应恶化。益生菌、抗生素和饮食改变也已作为可能的治疗方法进行了研究,以帮助RA患者恢复肠道微生物群的平衡。然而,肠道微生物群影响RA的确切方式仍有待讨论。了解肠道微生物群与RA之间的复杂联系可能会为该病的管理和预防提供新的视角,以及针对微生物群的药物的未来前景。