BJD:剪不断,理还乱~胃肠道微生物群与银屑病的关系

2022-06-05 医路坦克 MedSci原创

迄今为止的证据表明,银屑病与胃肠道失调有关。然而,鉴于我们才刚刚开始了解皮肤-肠道轴的复杂性,现在就对微生物组在银屑病中的作用及其治疗靶向性做出确切的结论还为时过早。

在过去的几年里,研究微生物组在自身免疫性疾病特别是银屑病中的作用的研究数量急剧增加。一开始皮肤微生物组的组成的变化是热点,但考虑到银屑病的全身炎症性质及其与炎症性肠病的关联,最近的研究主要集中在胃肠失衡在银屑病病理生理中的作用。

Todberg等人对银屑病患者和年龄、性别和体重指数匹配的健康对照的肠道菌群进行了研究,同时也提供了纵向数据来检查随着时间的推移胃肠道菌群的稳定性。也许这项研究最新颖的方面是,为了解决共同的环境因素,还对银屑病患者的健康同居伴侣的微生物组进行了调查。与16S rRNA测序相比,使用鸟枪宏基因组测序能够进行更详细和功能更强的微生物组分析。

银屑病患者具有明显的胃肠道菌群特征,其宏基因组物种丰富度明显低于健康对照组。有趣的是,虽然银屑病患者和他们的伴侣之间的物种多样性存在显著差异,但银屑病患者和健康对照组之间没有这种差异。在功能数据方面,银屑病患者的功能丰富度低于健康对照组及其伴侣。也有证据表明银屑病的严重程度与微生物组成有关;如放线菌门(Actinobacteria)和Euryarchaeota门和甲烷菌科(Methanobacteriaceae)在更严重的疾病中增加。相反,没有发现季节性对微生物群组成的影响,这与胃肠道微生物群表面上是稳定的证据相一致。

在翻阅我们的微生物学教科书来更新我们对细菌分类学的知识时,有必要停下来把结果放在背景中。目前已有一些研究报道了银屑病患者的胃肠道失调,但很少有纵向跟踪这些变化或提供膳食摄入的信息。Todberg等人的研究解决了几个限制,但没有包括病毒或真菌的宏基因组测序分析。另一方面,也提供了与疾病严重程度相关的功能数据,如甲烷杆菌科的丰度和丁酸生产潜力的下降。事实上,短链脂肪酸,包括丁酸,以其抗炎特性和对树突状细胞的免疫调节作用而闻名,减少白细胞介素-23的产生,促进原始淋巴细胞转化为调节性T细胞而不是T辅助细胞17。在饮食的一个重要环节中,红肉的摄入与胃肠道失调介导的丁酸合成减少有关,至少在小鼠中是这样。

抛开长期困扰微生物组研究的因果关系问题,迄今为止的证据表明,银屑病与胃肠道失调有关。然而,鉴于我们才刚刚开始了解皮肤-肠道轴的复杂性,现在就对微生物组在银屑病中的作用及其治疗靶向性做出确切的结论还为时过早。

文献来源:Langan EA,  Künstner A,The gastrointestinal microbiome and psoriasis: more food for thought.Br J Dermatol 2022 May 20; 

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    2022-06-28 ms4000001779351440

    有启发,忌口的必要性

    0

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    2022-06-05 屋顶瞄爱赏月

    签到

    0

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    2022-06-05 xulv123

    认真学习~~

    0

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