The role of microbiome in the pathogenesis of immune-mediated inflammatory diseases: controversial issues
https://doi.org/10.14412/1996-7012-2021-1-15-19
Abstract
Increasing attention in rheumatology is today paid to the detection of diseases at the earliest possible (preclinical) stages, which can contribute to a more favorable response to therapy. The preclinical period of a systemic autoimmune reaction is assumed to be related to dysregulation of immune interactions with the synanthropic microflora. A sequencing method was used to study deviations in the diversity of the gut microflora in patients with rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis. However, a number of unresolved issues remain, since the emphasis has been on the cataloguing of the microorganisms present and on the identification of correlations between microbial species and diseases. The main difference in future microbiome research in patients with immune-mediated inflammatory diseases should be a closer examination of the functions of microbiota components, and not just their description. Long-term studies with the collection of intestinal microbiome samples are required at several time intervals: before disease-modifying antirheumatic drug therapy and during ineffective therapy. Such studies will contribute to the development of new diagnostic and therapeutic interventions. Until they are completed, it is untimely to recommend microbiome analysis as a diagnostic or prognostic tool for the management of rheumatic diseases in clinical practice.
About the Authors
A. M. LilaRussian Federation
Department of Rheumatology Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia
34A, Kashirskoe Shosse, Moscow 115522,
2/1, Barrikadnaya St., Build. 1, Moscow 125993
E. A. Galushko
Russian Federation
Elena Andreevna Galushko
34A, Kashirskoe Shosse, Moscow 115522
A. V. Gordeev
Russian Federation
34A, Kashirskoe Shosse, Moscow 115522
A. S. Semashko
Russian Federation
34A, Kashirskoe Shosse, Moscow 115522
References
1. Duvallet C, Gibbons SM, Gurry T, et al. Meta-analysis of gut microbiome studies identifies disease-specific and shared responses. Nat Commun. 2017 Dec 5;8(1):1784. doi: 10.1038/s41467-017-01973-8.
2. Winthrop KL, Weinblatt ME, Bathon J, et al. Unmet need in rheumatology: reports from the Targeted Therapies meeting 2019. Ann Rheum Dis. 2020; Jan;79(1):88-93. doi: 10.1136/annrheumdis-2019-216151. Epub 2019 Oct 29.
3. Nasonov EL, Lila AM. Janus kinase inhibitors in immuno-inflammatory rheumatic diseases: new opportunities and prospects. Nauchno-prakticheskaya revmatologiya. 2019;57(1):8-16 (In Russ.).
4. Costello M, Robinson P, Benham H, et al. The intestinal microbiome in human disease and how it relates to arthritis and spondyloarthritis. Best Pract Res Clin Rheumatol. 2015 Apr;29(2):202-12. doi: 10.1016/j.berh.2015.08.001. Epub 2015 Aug 17.
5. Galushko EA, Gordeev AV. Modern idea on the pathogenesis of spondyloarthritis: Molecular mechanisms. Nauchno-prakticheskaya revmatologiya. 2013;53(3):299-307. (In Russ.).
6. Goldblatt F, O'Neill SG. Clinical aspects of autoimmune rheumatic diseases. Lancet. 2013 Aug 31;382 (9894):797-808. doi: 10.1016/S0140-6736(13)61499-3
7. Ruff WE, Kriegel MA. Autoimmune hostmicrobiota interactions at barrier sites and beyond. Trends Mol Med. 2015 Apr; 21(4): 233-44. doi: 10.1016/j.molmed.2015.02.006. Epub 2015 Mar 11.
8. Raza K, Gerlag DM. Preclinical inflammatory rheumatic diseases. Rheum Dis Clin North Am. 2014 Nov;40(4):569-80. doi: 10.1016/j.rdc.2014.07.001 Epub 2014 Sep 2.
9. Gordeev AV, Galushko EA, Savushkina NM, Lila AM. Is periodontitis a harbinger of rheumatoid arthritis? Nauchno-prakticheskaya revmatologiya. 2018;56(5):613-21. (In Russ.).
10. Galushko EA, Gordeev AV. The concept of barrier organ disease in the pathogenesis of spondyloarthritis. Nauchno-prakticheskaya revmatologiya. 2016;54(2):199-205. (In Russ.).
11. Ruff WE, Kriegel MA. Autoimmune host-microbiota interactions at barrier sites and beyond. Trends Mol Med. 2015 Apr; 21(4):233-44. doi: 10.1016/j.molmed.2015.02.006. Epub 2015 Mar 11.
12. Lee YH. Causal association of gut microbiome on the risk of rheumatoid arthritis: a Mendelian randomization study. Ann Rheum Dis. 2020 Jan 10:annrheumdis-2019- 216747. doi: 10.1136/annrheumdis-2019-216747. Epub ahead of print.
13. Moiseev S, Rameev V, Karovaikina E, et al. Gut microbiome in rheumatic diseases. Ann Rheum Dis. 2019 Nov 14;annrheumdis2019-216560. doi: 10.1136/annrheumdis2019-216560. Online ahead of print.
14. Costello ME, Ciccia F, Willner D, et al. Brief report: intestinal dysbiosis in ankylosing spondylitis. Arthritis Rheumatol. 2015 Mar; 67(3): 686-91.
15. Scher JU, Ubeda C, Artacho A, et al. Decreased bacterial diversity characterizes the altered gut microbiota in patients with psoriatic arthritis, resembling dysbiosis in inflammatory bowel disease. Arthritis Rheumatol. Jan;67(1):128-39. doi: 10.1002/art.38892.
16. Stoll ML Gut microbes, immunity, and spondyloarthritis. Clin Immunol. 2015 Aug; 159(2):134-42. doi: 10.1016/j.clim.2015.05.001. Epub 2015 May 9.
17. Huttenhower C, Kostic AD, Xavier RJ. Inflammatory bowel disease as a model for translating the microbiome. Immunity. 2014 Jun 19;40(6):843-54. doi: 10.1016/j.immuni.2014.05.013.
18. Van Praet L, van den Bosch FE, Jacques P, et al. Microscopic gut inflammation in axial spondyloarthritis: a multiparametric predictive model. Ann Rheum Dis. 2013 Mar;72(3):414-7. doi: 10.1136/annrheumdis-2012-202135. Epub 2012 Nov 8.
19. Telfer NR, Chalmers RJ, Whale K, et al. The role of streptococcal infection in the initiation of guttate psoriasis. Arch Dermatol. 1992 Jan;128:39-42.
20. Gao Z, Tseng CH, Strober BE, et al. Substantial alterations of the cutaneous bacterial biota in psoriatic lesions. PLoS One. 2008 Jul 23;3(7):e2719. doi: 10.1371/journal.pone.0002719
21. Castelino MS, Eyre S, Upton M, et al. The bacterial skin microbiome in psoriatic arthritis, an unexplored link in pathogenesis: challenges and opportunities offered by recent technological advances. Rheumatology (Oxford). 2014 May;53(5):777-84. doi: 10.1093/rheumatology/ket319. Epub 2013 Sep 24.
22. Maeda Y, Kurakawa T, Umemoto E, et al. Dysbiosis contributes to arthritis development via activation of autoreactive T cells in the intestine. Arthritis Rheumatol. 2016 Nov; 68(11):2646-61. doi: 10.1002/art.39783.
23. Pianta A, Arvikar S, Strle K, et al. Evidence of the immune relevance of Prevotella copri, a gut microbe, in patients with rheumatoid arthritis. Arthritis Rheumatol. 2017 May;69(5):964-75. doi: 10.1002/art.40003. Epub 2017 Apr 7.
24. Scher JU, Ubeda C, Equinda M, et al. Periodontal disease and the oral microbiota in new-onset rheumatoid arthritis. Arthritis Rheum. 2012 Oct;64(10):3083-94. doi: 10.1002/art.34539.
25. Manasson J, Blank RB, Scher JU. The microbiome in rheumatology: Where are we and where should we go? Ann Rheum Dis. 2020 Jun;79(6):727-33. doi: 10.1136/annrheumdis-2019-216631. Epub 2020 Apr 24.
26. Marotte H, Farge P, Gaudin P, et al. The association between periodontal disease and joint destruction in rheumatoid arthritis extends the link between the HLA-DR shared epitope and severity of bone destruction. Ann Rheum Dis. 2006 Jul;65(7):905-9. doi: 10.1136/ard.2005.036913. Epub 2005 Nov 10.
27. Garrett WS. Cancer and the microbiota. Science. 2015 Apr 3;348(6230):80-6. doi: 10.1126/science.aaa4972.
28. Pickard JM, Zeng MY, Caruso R, et al. Gut microbiota: role in pathogen colonization, immune responses, and inflammatory disease. Immunol Rev. 2017 Sep;279(1):70-89. doi: 10.1111/imr.12567.
29. Imdad A, Nicholson MR, Tanner-Smith EE, et al. Fecal transplantation for treatment of inflammatory bowel disease. Cochrane Database Syst Rev. 2018 Nov 13; 11(11):CD012774. doi: 10.1002/14651858.CD012774.pub2.
30. Frankel AE, Coughlin LA, Kim J, et al. Metagenomic shotgun sequencing and unbiased metabolomic profiling identify specific human gut microbiota and metabolites associated with immune checkpoint therapy efficacy in melanoma patients. Neoplasia. 2017 Oct;19(10):848-55. doi: 10.1016/j.neo.2017.08.004. Epub 2017 Sep 15.
31. Loomba R, Seguritan V, Li W, et al. Gut microbiome-based metagenomic signature for non-invasive detection of advanced fibrosis in human nonalcoholic fatty liver disease. Cell Metab. 2019 Sep 3;30(3):607. doi: 10.1016/j.cmet.2019.08.002.
32. Suez J, Zmora N, Zilberman-Schapira G, et al. Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT. Cell. 2018 Sep 6;174(6):1406-23.e16. doi: 10.1016/j.cell.2018.08.047.
33. Cammarota G, Masucci L, Ianiro G, et al. Randomised clinical trial: faecal microbiota transplantation by colonoscopy vs. vancomycin for the treatment of recurrent Clostridium difficile infection. Aliment Pharmacol Ther. 2015 May;41(9):835-43. doi: 10.1111/apt.13144. Epub 2015 Mar 1.
34. Allegretti JR, Mullish BH, Kelly C, et al. The evolution of the use of faecal microbiota transplantation and emerging therapeutic indications. Lancet. 2019 Aug 3;394(10196): 420-31. doi: 10.1016/S0140-6736(19)31266-8.
35. Sonnenburg, ED. & Sonnenburg, JL. The ancestral and industrialized gut microbiota and implications for human health. Nat Rev Microbiol. 2019 Jun;17(6):383-90. doi: 10.1038/s41579-019-0191-8.
36. Bazin T, Hooks KB, Barnetche T, et al. Microbiota composition may predict antiTNF alpha response in spondyloarthritis patients: an exploratory study. Sci Rep. 2018 Apr 3;8(1):5446. doi: 10.1038/s41598-018-23571-4.
Review
For citations:
Lila AM, Galushko EA, Gordeev AV, Semashko AS. The role of microbiome in the pathogenesis of immune-mediated inflammatory diseases: controversial issues. Sovremennaya Revmatologiya=Modern Rheumatology Journal. 2021;15(1):15-19. (In Russ.) https://doi.org/10.14412/1996-7012-2021-1-15-19