|
|
硬皮病与肠道菌群相关性的研究进展
|
Abstract:
硬皮病，又称系统性硬化症(Systemic Sclerosis, SSc)，是一种复杂的自身免疫性结缔组织疾病，其特征是皮肤和内脏器官的广泛纤维化、弥漫性微血管病变和免疫调节障碍。肠道菌群通过调节炎症和成纤维细胞分化过程从而促进了硬皮病患者的皮肤、肺、心脏和胃肠道组织的纤维化并且对免疫系统产生影响。该文综述了硬皮病患者的肠道菌群特征以及相关药物、营养支持、饮食干预、益生菌和粪便菌群移植在硬皮病治疗方面的最新研究进展，为临床防治硬皮病提供新的理念和方法。
Scleroderma, also known as Systemic Sclerosis (SSc), is a complex autoimmune connective tissue disease characterized by extensive fibrosis of the skin and internal organs, diffuse microangiopathy, and impaired immune regulation. The intestinal flora promotes fibrosis in skin, lung, heart and gastrointestinal tissues of scleroderma patients by regulating inflammatory and fibroblast differentiation processes and has an impact on the immune system. This article reviews the characteristics of the gut flora in scleroderma patients and recent research advances in the treatment of scleroderma with relevant medications, nutritional support, dietary interventions, probiotics, and fecal microbiota transplantation to provide new concepts and approaches for the clinical management of scleroderma.
| [1] | Lemos, M.P.C., Zucoloto, T.G., Oliveira, M.C. and de Oliveira, G.L.V. (2021) Dysbiosis and Gut Microbiota Modulation in Systemic Sclerosis. JCR: Journal of Clinical Rheumatology, 28, e568-e573. https://doi.org/10.1097/rhu.0000000000001748 |
| [2] | Nassar, M., Ghernautan, V., Nso, N., Nyabera, A., Castillo, F.C., Tu, W., et al. (2022) Gastrointestinal Involvement in Systemic Sclerosis: An Updated Review. Medicine, 101, e31780. https://doi.org/10.1097/md.0000000000031780 |
| [3] | McFarlane, I.M., Bhamra, M.S., Kreps, A., Iqbal, S., Al-Ani, F., Saladini-Aponte, C., Grant, C., Singh, S., Awwal, K., Koci, K., Saperstein, Y., Arroyo-Mercado, F.M., Laskar, D.B. and Atluri, P. (2018) Gastrointestinal Manifestations of Systemic Sclerosis. Rheumatology (Sunnyvale, Calif.), 8, 235. |
| [4] | Denton, C.P., Black, C.M. and Abraham, D.J. (2006) Mechanisms and Consequences of Fibrosis in Systemic Sclerosis. Nature Clinical Practice Rheumatology, 2, 134-144. https://doi.org/10.1038/ncprheum0115 |
| [5] | Thoua, N.M., Bunce, C., Brough, G., Forbes, A., Emmanuel, A.V. and Denton, C.P. (2010) Assessment of Gastrointestinal Symptoms in Patients with Systemic Sclerosis in a UK Tertiary Referral Centre. Rheumatology, 49, 1770-1775. https://doi.org/10.1093/rheumatology/keq147 |
| [6] | Franck-Larsson, K., Graf, W. and Rönnblom, A. (2009) Lower Gastrointestinal Symptoms and Quality of Life in Patients with Systemic Sclerosis: A Population-Based Study. European Journal of Gastroenterology & Hepatology, 21, 176-182. https://doi.org/10.1097/meg.0b013e32831dac75 |
| [7] | Donaldson, G.P., Lee, S.M. and Mazmanian, S.K. (2015) Gut Biogeography of the Bacterial Microbiota. Nature Reviews Microbiology, 14, 20-32. https://doi.org/10.1038/nrmicro3552 |
| [8] | Lozupone, C.A., Stombaugh, J.I., Gordon, J.I., Jansson, J.K. and Knight, R. (2012) Diversity, Stability and Resilience of the Human Gut Microbiota. Nature, 489, 220-230. https://doi.org/10.1038/nature11550 |
| [9] | 王艳婷, 金延春, 任科雨, 等. 肠道微生物-免疫轴与疾病[J]. 中国免疫学杂志, 2023, 39(5): 1112-1115+1122. |
| [10] | Schroeder, B.O. and Bäckhed, F. (2016) Signals from the Gut Microbiota to Distant Organs in Physiology and Disease. Nature Medicine, 22, 1079-1089. https://doi.org/10.1038/nm.4185 |
| [11] | McMahan, Z.H., Kulkarni, S., Chen, J., Chen, J.Z., Xavier, R.J., Pasricha, P.J., et al. (2023) Systemic Sclerosis Gastrointestinal Dysmotility: Risk Factors, Pathophysiology, Diagnosis and Management. Nature Reviews Rheumatology, 19, 166-181. https://doi.org/10.1038/s41584-022-00900-6 |
| [12] | Russo, E., Bellando-Randone, S., Carboni, D., Fioretto, B.S., Romano, E., Baldi, S., et al. (2023) The Differential Crosstalk of the Skin-Gut Microbiome Axis as a New Emerging Actor in Systemic Sclerosis. Rheumatology, 63, 226-234. https://doi.org/10.1093/rheumatology/kead208 |
| [13] | Hevia, A., Milani, C., López, P., Cuervo, A., Arboleya, S., Duranti, S., et al. (2014) Intestinal Dysbiosis Associated with Systemic Lupus Erythematosus. mBio, 5, e01548-14. https://doi.org/10.1128/mbio.01548-14 |
| [14] | Rogier, R., Evans-Marin, H., Manasson, J., van der Kraan, P.M., Walgreen, B., Helsen, M.M., et al. (2017) Alteration of the Intestinal Microbiome Characterizes Preclinical Inflammatory Arthritis in Mice and Its Modulation Attenuates Established Arthritis. Scientific Reports, 7, Article No. 15613. https://doi.org/10.1038/s41598-017-15802-x |
| [15] | Carroll, I.M., Ringel-Kulka, T., Ferrier, L., Wu, M.C., Siddle, J.P., Bueno, L., et al. (2013) Fecal Protease Activity Is Associated with Compositional Alterations in the Intestinal Microbiota. PLOS ONE, 8, e78017. https://doi.org/10.1371/journal.pone.0078017 |
| [16] | Gecse, K., Roka, R., Ferrier, L., Leveque, M., Eutamene, H., Cartier, C., et al. (2008) Increased Faecal Serine Protease Activity in Diarrhoeic IBS Patients: A Colonic Lumenal Factor Impairing Colonic Permeability and Sensitivity. Gut, 57, 591-599. https://doi.org/10.1136/gut.2007.140210 |
| [17] | Plichta, D.R., Somani, J., Pichaud, M., Wallace, Z.S., Fernandes, A.D., Perugino, C.A., et al. (2021) Congruent Microbiome Signatures in Fibrosis-Prone Autoimmune Diseases: IgG4-Related Disease and Systemic Sclerosis. Genome Medicine, 13, Article No. 35. https://doi.org/10.1186/s13073-021-00853-7 |
| [18] | Patrone, V., Puglisi, E., Cardinali, M., Schnitzler, T.S., Svegliati, S., Festa, A., et al. (2017) Gut Microbiota Profile in Systemic Sclerosis Patients with and without Clinical Evidence of Gastrointestinal Involvement. Scientific Reports, 7, Article No. 14874. https://doi.org/10.1038/s41598-017-14889-6 |
| [19] | Inan, M.S., Rasoulpour, R.J., Yin, L., Hubbard, A.K., Rosenberg, D.W. and Giardina, C. (2000) The Luminal Short-Chain Fatty Acid Butyrate Modulates NF-κB Activity in a Human Colonic Epithelial Cell Line. Gastroenterology, 118, 724-734. https://doi.org/10.1016/s0016-5085(00)70142-9 |
| [20] | Schwab, M., Reynders, V., Loitsch, S., Steinhilber, D., Stein, J. and Schröder, O. (2007) Involvement of Different Nuclear Hormone Receptors in Butyrate-Mediated Inhibition of Inducible NFκB Signalling. Molecular Immunology, 44, 3625-3632. https://doi.org/10.1016/j.molimm.2007.04.010 |
| [21] | Klampfer, L., Huang, J., Sasazuki, T., Shirasawa, S. and Augenlicht, L. (2003) Inhibition of Interferon Gamma Signaling by the Short Chain Fatty Acid Butyrate. Molecular Cancer Research: MCR, 1, 855-862. |
| [22] | Katsumoto, T.R., Whitfield, M.L. and Connolly, M.K. (2011) The Pathogenesis of Systemic Sclerosis. Annual Review of Pathology: Mechanisms of Disease, 6, 509-537. https://doi.org/10.1146/annurev-pathol-011110-130312 |
| [23] | Zhan, S., Li, N., Liu, C., Mao, R., Wu, D., Li, T., et al. (2021) Intestinal Fibrosis and Gut Microbiota: Clues from Other Organs. Frontiers in Microbiology, 12, Article 694967. https://doi.org/10.3389/fmicb.2021.694967 |
| [24] | Parker, B.J., Wearsch, P.A., Veloo, A.C.M. and Rodriguez-Palacios, A. (2020) The Genus Alistipes: Gut Bacteria with Emerging Implications to Inflammation, Cancer, and Mental Health. Frontiers in Immunology, 11, Article 906. https://doi.org/10.3389/fimmu.2020.00906 |
| [25] | Strahm, N., Didriksen, H., Fretheim, H., Molberg, Ø., Midtvedt, Ø., Farstad, I.N., et al. (2023) Effects of Faecal Microbiota Transplantation on the Small Intestinal Mucosa in Systemic Sclerosis. Rheumatology, 62, 2918-2929. https://doi.org/10.1093/rheumatology/kead014 |
| [26] | 李凯园, 独艳然, 宋丹琳, 等. 普芦卡必利治疗慢性功能性便秘有效性和安全性的Meta分析[J]. 胃肠病学, 2021, 26(8): 471-476. |
| [27] | Bures, J. (2010) Small Intestinal Bacterial Overgrowth Syndrome. World Journal of Gastroenterology, 16, 2978-2990. https://doi.org/10.3748/wjg.v16.i24.2978 |
| [28] | Ferreli, C., Gasparini, G., Parodi, A., Cozzani, E., Rongioletti, F. and Atzori, L. (2017) Cutaneous Manifestations of Scleroderma and Scleroderma-Like Disorders: A Comprehensive Review. Clinical Reviews in Allergy & Immunology, 53, 306-336. https://doi.org/10.1007/s12016-017-8625-4 |
| [29] | Murtaugh, M.A. and Frech, T.M. (2013) Nutritional Status and Gastrointestinal Symptoms in Systemic Sclerosis Patients. Clinical Nutrition, 32, 130-135. https://doi.org/10.1016/j.clnu.2012.06.005 |
| [30] | Marie, I., Leroi, A., Gourcerol, G., Levesque, H., Menard, J. and Ducrotte, P. (2016) Lactose Malabsorption in Systemic Sclerosis. Alimentary Pharmacology & Therapeutics, 44, 1123-1133. https://doi.org/10.1111/apt.13810 |
| [31] | 张星弛, 韩培涛, 李晓莉, 等. 中链甘油三酯的研究进展[J]. 食品研究与开发, 2017, 38(23): 220-224. |
| [32] | García-Collinot, G., Madrigal-Santillán, E.O., Martínez-Bencomo, M.A., Carranza-Muleiro, R.A., Jara, L.J., Vera-Lastra, O., et al. (2019) Effectiveness of Saccharomyces boulardii and Metronidazole for Small Intestinal Bacterial Overgrowth in Systemic Sclerosis. Digestive Diseases and Sciences, 65, 1134-1143. https://doi.org/10.1007/s10620-019-05830-0 |
| [33] | Frech, T.M., Khanna, D., Maranian, P., Frech, E.J., Sawitzke, A.D. and Murtaugh, M.A. (2011) Probiotics for the Treatment of Systemic Sclerosis-Associated Gastrointestinal Bloating/Distention. Clinical and Experimental Rheumatology, 29, S22-S25. |
| [34] | 戴张晗, 郑青, 冉志华, 等. 粪便菌群移植在炎症性肠病治疗中的应用[J]. 中华消化杂志, 2014, 34(4): 283-285. |
