人类肠道微生物组对治疗自身免疫性疾病的影响。

IF 7.5 2区 医学 Q1 IMMUNOLOGY Immunological Reviews Pub Date : 2024-06-12 DOI:10.1111/imr.13358
Renuka R. Nayak, Diego A. Orellana
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引用次数: 0

摘要

自身免疫性(或风湿性)疾病的发病率越来越高,但为每位患者选择最佳疗法的过程却充满了反复试验。这种策略可能导致治疗无效,造成不可逆转的损害和痛苦;因此,有必要为自身免疫性疾病患者带来精准医疗的希望。虽然宿主因素在一定程度上决定了对免疫抑制剂的治疗反应,但这些因素并未被常规用于定制治疗。因此,非宿主因素很可能起作用。在此,我们考虑了人类肠道微生物组在自身免疫疾病治疗中的影响。我们提出,可以通过操纵肠道微生物组来改善治疗,并从现有疗法中获得更大的益处。我们将重点放在人类肠道微生物组影响治疗反应的机制上,提供了一个研究这些机制的框架,回顾了一个广泛使用的抗风湿药物的案例研究,并讨论了研究多个复杂系统(微生物组、人类免疫系统和自身免疫疾病)所面临的挑战。我们探讨了该领域的未决问题,并推测了药物-微生物组-自身免疫性疾病相互作用的未来。最后,我们提出了如何利用微生物组为风湿病患者带来精准医疗希望的蓝天愿景。
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The impact of the human gut microbiome on the treatment of autoimmune disease

Autoimmune (or rheumatic) diseases are increasing in prevalence but selecting the best therapy for each patient proceeds in trial-and-error fashion. This strategy can lead to ineffective therapy resulting in irreversible damage and suffering; thus, there is a need to bring the promise of precision medicine to patients with autoimmune disease. While host factors partially determine the therapeutic response to immunosuppressive drugs, these are not routinely used to tailor therapy. Thus, non-host factors likely contribute. Here, we consider the impact of the human gut microbiome in the treatment of autoimmunity. We propose that the gut microbiome can be manipulated to improve therapy and to derive greater benefit from existing therapies. We focus on the mechanisms by which the human gut microbiome impacts treatment response, provide a framework to interrogate these mechanisms, review a case study of a widely-used anti-rheumatic drug, and discuss challenges with studying multiple complex systems: the microbiome, the human immune system, and autoimmune disease. We consider open questions that remain in the field and speculate on the future of drug–microbiome–autoimmune disease interactions. Finally, we present a blue-sky vision for how the microbiome can be used to bring the promise of precision medicine to patients with rheumatic disease.

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来源期刊
Immunological Reviews
Immunological Reviews 医学-免疫学
CiteScore
16.20
自引率
1.10%
发文量
118
审稿时长
4-8 weeks
期刊介绍: Immunological Reviews is a specialized journal that focuses on various aspects of immunological research. It encompasses a wide range of topics, such as clinical immunology, experimental immunology, and investigations related to allergy and the immune system. The journal follows a unique approach where each volume is dedicated solely to a specific area of immunological research. However, collectively, these volumes aim to offer an extensive and up-to-date overview of the latest advancements in basic immunology and their practical implications in clinical settings.
期刊最新文献
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