人类微生物与系统性自身免疫性风湿性疾病的免疫抑制治疗相互作用吗? 一个系统的审查
Noemí Franco-Domingo1, Patricia Saiz-López2, Loreto Carmona-Ortells3
1Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain.
Reumatologia clinica
|August 29, 2025
概括
对人类微生物群 (HM) 和自身免疫性疾病 (ARDs) 免疫抑制治疗的研究表明存在潜在的联系. 肠道微生物群的变化可能会影响治疗反应,但需要更多的标准化研究.
科学领域:
- 免疫学和微生物学
- 关节病学
- 胃肠病学
背景情况:
- 系统性自身免疫性风湿病 (ARDs) 涉及免疫系统与外部因素之间的复杂相互作用.
- 免疫抑制药物治疗对于治疗ARD至关重要,但它们的疗效在不同患者之间可能有很大差异.
- 人类微生物群 (HM),特别是肠道微生物群,因其在免疫系统调节中的作用而越来越受认可.
研究的目的:
- 系统地审查和分析人类微生物群与系统性自身免疫性风湿病患者的免疫抑制治疗之间的相互作用.
- 评估这些相互作用对疾病活性和治疗反应的影响.
- 发现当前研究的差距,并建议未来研究的方向.
主要方法:
- 通过使用电子数据库 (Medline,Embase,Cochrane图书馆) 进行了系统审查,直到2024年2月.
- 包括的研究集中在患有ARD的成年患者身上 (不包括脊椎关节炎),研究HM和IS治疗之间的相互作用,测量多样性和分类组合.
- 考虑了任何语言的研究,优先考虑临床试验,包括观察和病例对照设计.
主要成果:
- 包括20项研究 (15项关于类风湿性关节炎,3项关于全身性红斑狼,1项关于原发性谢格伦综合征,1项关于全身性硬化症),偏差的总体风险中等.
- 由于研究的稀缺性和特异性,研究主要局限于肠道微生物群.
- 一种趋势表明肠道微生物群的多样性和组成变化减少,IS治疗的患者部分恢复.
结论:
- 目前的证据表明,人类微生物群与自身免疫性风湿性疾病中免疫抑制疗法的反应之间存在潜在的关联.
- 证据的质量和方法的多样性限制了最终的结论.
- 微生物群研究方法的标准化对于整合数据和得出更强有力的推断至关重要.
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