Ajith Thekkuttuparambil Ananthanarayanan, Anita Bejoy
Department of Biochemistry, and Amala Integrated Medical Research Department, Amala Institute of Medical Sciences, Thrissur, Kerala, India.
Department of General Medicine, Amala Institute of Medical Sciences, Thrissur, Kerala, India.
Int J Rheum Dis. 2025 May;28(5):e70266. doi: 10.1111/1756-185X.70266.
Over the past few decades, there has been a surge in global study on the relationship between gut microbiota and human health. Numerous human illnesses have been linked to dysbiosis. Gram-positive firmicutes and Gram-negative bacteroidetes are the two leading bacterial phyla that make up 90% of the gut microbiome. Many symbionts in the gut environment establish intricate relationships with host defense to stop both local and non-native dangerous bacteria from colonizing and invading. Dysbiosis alters the paracellular route and damages the epithelium, enabling them to penetrate the epithelium and come into contact with the immune cells. Impaired intestinal barrier function, immune regulation mediated by metabolites derived from the gut microbiota, posttranslational modification of host proteins such as increased citrullination, regulation of the gut microbiota's effect on immune cells, intestinal epithelial cell autophagy, interaction between the microbiome and human leukocyte antigen alleles, and interaction with microRNAs are some of the mechanisms involved in rheumatoid arthritis (RA). The gut microbiota, Prevotella copri, and Collinsella spp. were shown to be higher in the early/preclinical phases of RA, while Bacteroidetes, Bifidobacteria, and Eubacterium rectale were found to be lower. Probiotic-based early dietary intervention may reduce inflammation and slow the rate of joint deterioration, and such intervention can also aid in the restoration of gut microbiota equilibrium. This review article describes the gut microbial dysbiosis and role of probiotics in RA.
在过去几十年中，全球对肠道微生物群与人类健康之间关系的研究激增。许多人类疾病都与微生物群失调有关。革兰氏阳性厚壁菌门和革兰氏阴性拟杆菌门是构成肠道微生物组90%的两个主要细菌门类。肠道环境中的许多共生体与宿主防御建立了复杂的关系，以阻止本地和外来危险细菌的定殖和入侵。微生物群失调会改变细胞旁途径并损害上皮细胞，使它们能够穿透上皮细胞并与免疫细胞接触。肠道屏障功能受损、由肠道微生物群衍生的代谢物介导的免疫调节、宿主蛋白的翻译后修饰（如瓜氨酸化增加）、肠道微生物群对免疫细胞作用的调节、肠道上皮细胞自噬、微生物组与人类白细胞抗原等位基因之间的相互作用以及与微小RNA的相互作用，都是类风湿性关节炎（RA）涉及的一些机制。在RA的早期/临床前期阶段，肠道微生物群、普氏粪杆菌和柯林斯菌属的含量较高，而拟杆菌门、双歧杆菌和直肠真杆菌的含量较低。基于益生菌的早期饮食干预可能会减轻炎症并减缓关节恶化速度，这种干预还可以帮助恢复肠道微生物群的平衡。这篇综述文章描述了肠道微生物群失调以及益生菌在RA中的作用。
