禁食后的肠道微生物群减少揭示了在类风湿性关节炎中炎症的微生物触发
Thomas Häupl1,2,3, Till Sörensen1, Biljana Smiljanovic1
1Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Berlin, 10117 Berlin, Germany.
Journal of clinical medicine
|July 14, 2023
概括
禁食和肠道清洁减少了类风湿性关节炎 (RA) 患者的肠道微生物,改善了疾病活动并减少了炎症标志物. 这表明肠道失调和RA之间存在联系,支持营养干预.
科学领域:
- 免疫学 免疫学 免疫学
- 微生物组研究的研究.
- 胃肠病学 胃肠病学
背景情况:
- 类风湿性关节炎 (RA) 综合炎涉及具有类似于微生物刺激的炎症模式的单细胞/巨细胞.
- 肠道微生物组在RA病变发生中的作用正在研究中.
研究的目的:
- 研究通过禁食和肠道清洁减少肠道微生物群对RA疾病活性和免疫参数的影响.
- 探索肠道失调和RA特异性炎症之间的关系.
主要方法:
- 一项涉及20名RA患者的开放性研究,这些患者接受了肠道清洗和7天的禁食 (≤250千卡/天).
- 免疫监测,微生物组测序和疾病活性评分 (DAS28/SDAI),IL-6,佐努林和皮质醇水平的测量.
- 包括一个由10名代谢综合征患者组成的对照组.
主要成果:
- 疾病活性评分 (DAS28/SDAI) 在几天内显著下降,20名RA患者中有19名在禁食后出现改善.
- 在6名患者 (DAS28 < 2.6) 和3名患者 (SDAI < 3.3) 中实现了缓解.
- 禁食减少了单细胞的循环,血清IL-6和zonulin水平,同时增加了内源性皮质醇. 微生物组测序显示,潜在的关节致病细菌减少,真核生物,主要是真菌,殖民者增加.
结论:
- 肠道微生物群和RA特异性炎症之间存在直接联系.
- 在RA中,肠道失调可能是病因相关的.
- 针对性营养干预以解决肠道失调症,代表了RA的潜在因果治疗方法.
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