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Reumatologia/Rheumatology
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4/2020
vol. 58
 
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How the gut microbiota contributes to changes of autoimmune phenotype – from molecular studies to clinical utility

Agnieszka Paradowska-Gorycka
1
,
Anna Wajda
1

1.
Department of Molecular Biology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
Data publikacji online: 2020/08/31
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Analyzing the current state of knowledge about the microbiota and the microbiome, nobody would expect that microorganisms living in the human body would have such a huge impact on our health state and the pathogenesis of many entities. The idea that gut microorganisms could affect the development of inflammatory bowel diseases seems to be quite rational, but a connection with depression seems rather tenuous. Surprisingly, a link between the gut-brain axis and microbiota also exists [1].
Nevertheless, long before the investigation of the microbiome became technically possible, it was suggested that gut microbes are involved in autoimmunity, leading to clinical inflammatory arthritis. The occurrence of inflammatory and autoimmune diseases, including rheumatic diseases, has been growing worldwide, but at the same time, we can also observe increased physician knowledge and earlier diagnosis. Moreover, research on the microbiome results mostly from the development of new, high-throughput technologies.
To date, the cause of rheumatic diseases is not fully understood, but it is believed that a combination of genetic and environmental factors is involved in their pathogenesis. Despite the constant evolution of the knowledge about its epidemiology, genetic susceptibility and pathophysiological mechanisms, rheumatic diseases remain disorders with a very variable course and significant inter-individual variability. They have an unpredictable prognosis, depending mainly on the severity of disease activity, organ damage, and response to the treatment. Recently, disturbed microbial composition and function, defined as “dysbiosis”, has been proposed as one of the potential mechanisms that may be important for the autoimmune rheumatic disease phenotype [2, 3]. However, the links between rheumatic diseases and the microbiome remain largely unknown.
Unicellular organisms were pioneers in the evolution of the Earth’s ecosystem. The co-evolution of bacteria and other symbiotic microbes such as archaea, viruses, fungi, and protozoa with their multicellular hosts has gradually built a unique micro-ecosystem, termed the “microbiota”, whereas microbes with their genomic elements are defined as the microbiome [4].
Microorganisms can implant on open surfaces such as the skin, digestive tract, respiratory system and urogenital tract and develop into local microflora with distinctive features. Overall, the microflora shares a survival niche with its hosts,...


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