Immunomodulatory Roles of Faecalibacterium prausnitzii and Akkermansia muciniphila in Autoimmune Diseases: Mechanistic Insights and Therapeutic Potential.

Abstract

Alterations in gut microbiota composition are increasingly recognized as key contributors to autoimmune disease pathogenesis. While dominant phyla such as Firmicutes and Bacteroidetes have been extensively studied at the phylum level, the immunomodulatory roles of specific members within these groups particularly the abundant but mechanistically underexplored Faecalibacterium prausnitzii (a member of Firmicutes) and Akkermansia muciniphila (of Verrucomicrobia) remain insufficiently characterized. In particular, current literature primarily focuses on associative findings, and integrated analyses elucidating disease-specific mechanisms and therapeutic relevance are still lacking. In this review, we synthesize mechanistic and disease-specific evidence regarding these two bacterial species across six autoimmune diseases, including systemic lupus erythematosus (SLE), type 1 diabetes (T1D), and rheumatoid arthritis (RA). F. prausnitzii is consistently depleted in autoimmune contexts and exerts protective effects through multiple mechanisms, including short-chain fatty acid (SCFA) production, histone deacetylase (HDAC) inhibition, Treg induction, secretion of microbial anti-inflammatory molecules (MAM), enhancement of epithelial barrier integrity, and modulation of pro- and anti-inflammatory cytokine responses. In contrast, A. muciniphila modulates mucosal immunity via Toll-like receptor 2 (TLR2) activation and tight junction enhancement but exhibits more variable patterns depending on disease and host context. This review offers an integrative framework comparing how these two taxa influence shared immune pathways such as the Th17/Treg axis, SCFA-G protein-coupled receptor (GPR) signaling, and epithelial barrier modulation across distinct autoimmune phenotypes. We also discuss therapeutic implications, including their roles as next-generation probiotics and the translational challenges of clinical application. By focusing on two mechanistically distinct but clinically relevant microbes, this review bridges current knowledge gaps and highlights promising directions for precision microbiome interventions in autoimmune diseases.