腸道菌叢在兒童特發性關節炎角色之研究

The role of gut microbiome in juvenile idiopathic arthritis

張簡晴瑩(Ching- Ying Changchien)

指導教授 ： 江伯倫

國立臺灣大學/醫學院/臨床醫學研究所/碩士(2019年)

https://doi.org/10.6342/NTU201903347

摘要

幼年型風濕性關節炎（JIA）為孩童最常見的風濕疾病，臺灣地區 JIA 之發生率為每年每十萬人有 4.9 ~ 15.7 人。目前JIA的發病機制尚不清楚，多種可能機制導致這種疾病，包括遺傳背景，發炎細胞因子和抗發炎細胞因子產生之間的調節不平衡。近年的研究數據顯示，腸道微生物群和自體免疫相關關節炎也有密切相關性存在，以及經治療關節炎可以部分恢復失衡腸道菌叢。本研究目的，在於了解關節炎治療對於腸道菌叢的影響。本結果顯示，JIA患者的腸道微生物組成在抗風濕藥物（DMARDs）治療組中比起生物製劑（TNFi），與健康對照組更相似。此外，我們追踪患者的腸道微生物群從DMARDs治療到生物製劑（TNFi）治療，並發現經治療後即使疾病狀況受到更好的控制，也可能改變腸道微生物群的組成。我們將這些JIA兒童與他們的兄弟姐妹健康對照組腸道微生物進行比較，結果顯示了類似於健康對照組發現。從此研究中，我們發現由於治療效果對腸道微生物影響，因此應該更仔細地解讀JIA中的dybiosis對疾病的影響。

關鍵字

兒童特發性關節炎 ； 腸道菌叢

並列摘要

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children. The pathogenesis of JIA was still unclear. Multiple factors might contribute to this disease, including genetic background, imbalance regulation between inflammatory and anti-inflammatory cytokines production. The mounting data showed that the gut microbiota might also be related to JIA and treatment in arthritis could also restore partial healthy gut microbiome. The aim of this study is to realize the treatment effect on JIA children. We compared the fecal microbiota of JIA children under different treatment regiment to healthy control (HC). The result revealed the gut microbiome of JIA patients under disease-modifying antirheumatic drugs (DMARDs) therapy was more similar to HC than patients under tumor necrosis factor inhibitor (TNFi) agents. Also, we trace patient’s gut microbiota from DMARDs therapy to TNFi therapy and found that treatment may change the composition of gut microbiota, even though disease status was under better control. We further compared these JIA children to their sibling HC, and the result showed similar finding with the result of comparing to healthy control. From this study, we found that dysbiosis in JIA should be interpreted more carefully.

並列關鍵字

Juvenile idiopathic arthritis ； Gut microbiome

參考文獻

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