关于肠道稳态和免疫系统如何相互作用形成强直性脊柱炎的机制性见解
Mechanistic insights into how gut homeostasis and immune-system crosstalk shape ankylosing spondylitis.
摘要(中文译文)
强直性脊柱炎（AS）是一种慢性免疫介导的炎症性疾病，主要累及中轴骨骼和附着点结构。尽管HLA-B27的作用已得到充分证实，但AS的发病机制具有多因素性，越来越多的证据提示肠道稳态的破坏及肠-关节轴可能参与疾病病理生物学过程。AS相关的肠道菌群失调以微生物多样性降低和群落组成改变为特征，这些改变可能与黏膜免疫激活、肠道通透性增加及全身性炎症启动相关。在机制层面，改变的微生物信号与屏障功能障碍可能汇聚于关键免疫通路，包括IL-23/IL-17轴，并可能促进固有样淋巴细胞（如MAIT细胞、γδ T细胞和ILC3s）的活化或迁移，从而参与炎症及异常骨重塑。除群落结构外，微生物代谢产物（包括短链脂肪酸和色氨酸衍生的吲哚类代谢物）有助于调节上皮完整性和免疫调节稳态；其紊乱可能促进与AS相关的促炎免疫程序。本综述总结了肠-关节轴中菌群失调、屏障功能障碍及免疫代谢信号传导的最新证据，并审慎区分了已确立的免疫靶向治疗与实验性微生物群导向策略及联合策略。
Abstract
Ankylosing spondylitis (AS) is a chronic immune-mediated inflammatory disease that primarily affects the axial skeleton and entheseal structures. Although the role of HLA-B27 is well established, AS pathogenesis is multifactorial, and accumulating evidence suggests that disruption of intestinal homeostasis and the gut-joint axis may contribute to disease pathobiology. AS-associated gut dysbiosis is characterized by reduced microbial diversity and compositional alterations that may be associated with mucosal immune activation, increased intestinal permeability, and systemic inflammatory priming. Mechanistically, altered microbial signals and barrier dysfunction may converge on key immunological pathways, including the IL-23/IL-17 axis, and may promote the activation or trafficking of innate-like lymphocytes, such as MAIT cells, γδ T cells, and ILC3s, thereby contributing to inflammation and abnormal bone remodeling. In addition to community structure, microbial metabolites, including short-chain fatty acids and tryptophan-derived indole metabolites, help regulate epithelial integrity and immunoregulatory homeostasis; their perturbation may favor pro-inflammatory immune programs relevant to AS. This review summarizes recent evidence on dysbiosis, barrier dysfunction, and immunometabolic signaling in the gut-joint axis, while critically distinguishing established immune-targeted therapies from experimental microbiota-directed and combination strategies.
如何引用
AMA
Jiawen Li, Xingwen Xie. Mechanistic insights into how gut homeostasis and immune-system crosstalk shape ankylosing spondylitis.. Frontiers in immunology. 2026; doi:10.3389/fimmu.2026.1809165.
APA
Jiawen Li, Xingwen Xie (2026). Mechanistic insights into how gut homeostasis and immune-system crosstalk shape ankylosing spondylitis.. Frontiers in immunology. https://doi.org/10.3389/fimmu.2026.1809165
GB/T 7714
Jiawen Li, Xingwen Xie. Mechanistic insights into how gut homeostasis and immune-system crosstalk shape ankylosing spondylitis.[J]. Frontiers in immunology, 2026 doi:10.3389/fimmu.2026.1809165.
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