Abstract：
Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by inflammation and joint damage. Existing treatment options primarily focus on managing symptoms and slowing disease progression, often with side effects and limitations. The gut microbiome, a vast community of microorganisms present in the gastrointestinal tract, plays a crucial role in health and disease. Recent research suggests a bidirectional relationship between the gut microbiome and RA, highlighting its potential as a therapeutic option. This review focuses on the interaction between the gut microbiome and RA development, by discussing how dysbiosis, an imbalance in gut bacteria, can contribute to RA through multiple mechanisms such as molecular mimicry, leaky gut, and metabolic dysregulation. Probiotics, live microorganisms with health benefits, are emerging as promising tools for managing RA. They can prevent the negative effects of dysbiosis by displacing harmful bacteria, producing anti-inflammatory metabolites like short-chain fatty acids (SCFA), Directly influencing immune cells, and modifying host metabolism. animal and clinical studies demonstrate the potential of probiotics in improving RA symptoms and disease outcomes. However, further research is needed to optimize probiotic strains, dosages, and treatment protocols for personalized and effective management of RA. This review summarizes the current understanding of the gut microbiome and its role in RA and discusses future research directions. In addition to the established role of gut dysbiosis in RA, emerging strategies like fecal microbiota transplantation, prebiotics, and postbiotics offer exciting possibilities. However, individual variations in gut composition necessitate personalized treatment plans. Long-term effects and clear regulations need to be established. Future research focusing on metagenomic analysis, combination therapies, and mechanistic understanding will unlock the full potential of gut microbiome modulation for effective RA management.
摘要：
类风湿性关节炎(RA)是一种以炎症和关节损害为特征的慢性自身免疫性疾病。现有的治疗方案主要集中在控制症状和减缓疾病进展。经常有副作用和局限性。肠道微生物组，胃肠道中存在的大量微生物群落，在健康和疾病中起着至关重要的作用。最近的研究表明，肠道微生物组和RA之间存在双向关系，强调其作为治疗选择的潜力。本文综述了肠道菌群与RA发生发展之间的相互作用,通过讨论菌群失调，肠道细菌的不平衡，可以通过多种机制促进RA，如分子模仿，漏肠,和代谢失调。益生菌,具有健康益处的活微生物，正在成为管理RA的有前途的工具。它们可以通过取代有害细菌来防止生态失调的负面影响，产生抗炎代谢产物，如短链脂肪酸（SCFA），直接影响免疫细胞，和改变宿主的新陈代谢。动物和临床研究表明，益生菌在改善RA症状和疾病结局方面具有潜力。然而,需要进一步的研究来优化益生菌菌株，剂量,和治疗方案，以实现RA的个性化和有效管理。本文综述了目前对肠道菌群及其在RA中的作用的认识，并讨论了未来的研究方向。除了肠道生态失调在RA中的作用外，新兴的策略，如粪便微生物群移植，益生元,和postbiotics提供令人兴奋的可能性。然而,肠道成分的个体差异需要个性化的治疗计划。需要建立长期影响和明确的规定。未来的研究侧重于宏基因组分析，联合疗法,和机制的理解将释放肠道微生物组调节的全部潜力，以实现有效的RA管理。
