自身免疫中的肠道皮肤和肠道甲状腺轴：银屑病和桥本甲状腺炎中的失调、微生物代谢产物、免疫失调和饮食的作用
The Gut-Skin and Gut-Thyroid Axis in Autoimmunity: Roles of Dysbiosis, Microbial Metabolites, Immune Dysregulation, and Diet in Psoriasis and Hashimoto's Thyroiditis.
摘要(中文译文)
银屑病与桥本甲状腺炎是慢性免疫介导性疾病，分别累及不同的靶器官，但共享重叠的发病机制，包括肠道菌群失调、肠道屏障功能受损及全身免疫调节异常。越来越多的证据表明，肠-皮肤轴和肠-甲状腺轴是连接微生物改变与免疫介导性炎症的重要界面。本综述旨在综合目前关于银屑病和桥本甲状腺炎中肠道菌群改变的知识，特别关注肠道通透性、免疫通路及微生物组衍生代谢物。本综述采用叙述性综述方法，纳入实验研究和人体观察性研究，评估银屑病和桥本甲状腺炎中肠道菌群组成、肠道屏障完整性、免疫调节、胆汁酸代谢及饮食影响的证据。纳入了探讨机制通路和临床相关性的相关文献。两种疾病均与肠道微生物组成改变相关，包括产短链脂肪酸菌群丰度降低，这可能损害上皮屏障完整性并促进全身免疫激活。两种疾病均报道有肠道通透性增加和Th17驱动的炎症反应增强。近期研究提示，胆汁酸代谢失调可能沿肠-皮肤-甲状腺轴影响肠道通透性和免疫平衡，但直接临床数据仍然有限。饮食模式，尤其是抗炎饮食和地中海饮食，始终与微生物多样性增加、代谢谱改善及全身炎症减轻相关。然而，大多数人体证据为观察性研究。肠道微生物组是连接饮食、肠道屏障功能、免疫调节与银屑病和桥本甲状腺炎器官特异性自身免疫之间的潜在机制纽带。尽管微生物组靶向干预在生物学上具有合理性，但仍需设计良好、基于机制信息的随机对照试验来确立因果关系和临床相关性。
Abstract
: Psoriasis and Hashimoto's thyroiditis are chronic immune-mediated disorders affecting distinct target organs but sharing overlapping pathogenic mechanisms, including gut dysbiosis, impaired intestinal barrier function, and systemic immune dysregulation. Growing evidence highlights the gut-skin and gut-thyroid axes as important interfaces linking microbial alterations to immune-mediated inflammation. This review aims to synthesize current knowledge on gut microbiota alterations in psoriasis and Hashimoto's thyroiditis, with particular emphasis on intestinal permeability, immune pathways, and microbiome-derived metabolites. : A narrative review of experimental and human observational studies was conducted to evaluate evidence on gut microbiota composition, intestinal barrier integrity, immune regulation, bile acid metabolism, and dietary influences in psoriasis and Hashimoto's thyroiditis. The relevant literature examining mechanistic pathways and clinical associations was included. : Both conditions are associated with altered gut microbial composition, including reduced abundance of short-chain fatty acid-producing taxa, which may impair epithelial barrier integrity and promote systemic immune activation. Increased intestinal permeability and enhanced Th17-driven inflammatory responses are reported in both diseases. Recent studies suggest that dysregulated bile acid metabolism may influence intestinal permeability and immune balance along the gut-skin-thyroid axis, although direct clinical data remain limited. Dietary patterns, particularly anti-inflammatory and Mediterranean diets, are consistently associated with increased microbial diversity, improved metabolic profiles, and reduced systemic inflammation. However, most human evidence is observational. : The gut microbiome represents a potential mechanistic link connecting diet, intestinal barrier function, immune regulation, and organ-specific autoimmunity in psoriasis and Hashimoto's thyroiditis. While microbiome-targeted interventions show biological plausibility, well-designed, mechanistically informed randomized controlled trials are required to establish causality and clinical relevance.
如何引用
AMA
Sabīna Ribačuka, Sabīne Upmale-Engela, Ieva Vaivode, Ilze Konrade, Māra Rone-Kupfere. The Gut-Skin and Gut-Thyroid Axis in Autoimmunity: Roles of Dysbiosis, Microbial Metabolites, Immune Dysregulation, and Diet in Psoriasis and Hashimoto's Thyroiditis.. Nutrients. 2026; doi:10.3390/nu18101501.
APA
Sabīna Ribačuka, Sabīne Upmale-Engela, Ieva Vaivode, Ilze Konrade, Māra Rone-Kupfere (2026). The Gut-Skin and Gut-Thyroid Axis in Autoimmunity: Roles of Dysbiosis, Microbial Metabolites, Immune Dysregulation, and Diet in Psoriasis and Hashimoto's Thyroiditis.. Nutrients. https://doi.org/10.3390/nu18101501
GB/T 7714
Sabīna Ribačuka, Sabīne Upmale-Engela, Ieva Vaivode, Ilze Konrade, Māra Rone-Kupfere. The Gut-Skin and Gut-Thyroid Axis in Autoimmunity: Roles of Dysbiosis, Microbial Metabolites, Immune Dysregulation, and Diet in Psoriasis and Hashimoto's Thyroiditis.[J]. Nutrients, 2026 doi:10.3390/nu18101501.
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