Microbiota and immune dynamics in rheumatoid arthritis: Mechanisms and therapeutic potential

IF 4.5 2区医学 Q1 RHEUMATOLOGY

Best Practice & Research in Clinical Rheumatology Pub Date : 2025-03-01 DOI:10.1016/j.berh.2025.102035

Jiayang Jin , Xuanlin Cai , Peishi Rao , Jun Xu , Jing Li

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引用次数: 0

Abstract

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.

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类风湿关节炎的微生物群和免疫动力学：机制和治疗潜力。

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在其发病机制中起关键作用。这篇综述探讨了微生物生态失调在类风湿关节炎中的多方面作用，强调其对免疫细胞调节、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微生物类群相互作用以影响疾病易感性。生态失调导致的代谢紊乱，包括短链脂肪酸和胆汁酸的改变，进一步加剧免疫失调和全身性炎症。新兴的治疗策略——益生菌、微生物代谢物、粪便微生物群移植和抗生素——为恢复微生物平衡和减缓疾病进展提供了创新的途径。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RA管理的潜力，并强调了进一步研究以利用微生物群的治疗潜力的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Best Practice & Research in Clinical Rheumatology 医学-风湿病学

CiteScore

9.40

自引率

0.00%

发文量

审稿时长

27 days

期刊介绍： Evidence-based updates of best clinical practice across the spectrum of musculoskeletal conditions. Best Practice & Research: Clinical Rheumatology keeps the clinician or trainee informed of the latest developments and current recommended practice in the rapidly advancing fields of musculoskeletal conditions and science. The series provides a continuous update of current clinical practice. It is a topical serial publication that covers the spectrum of musculoskeletal conditions in a 4-year cycle. Each topic-based issue contains around 200 pages of practical, evidence-based review articles, which integrate the results from the latest original research with current clinical practice and thinking to provide a continuous update. Each issue follows a problem-orientated approach that focuses on the key questions to be addressed, clearly defining what is known and not known. The review articles seek to address the clinical issues of diagnosis, treatment and patient management. Management is described in practical terms so that it can be applied to the individual patient. The serial is aimed at the physician in both practice and training.