重症肌无力与肠道微生物群关系

Relationship between Myasthenia Gravis and Intestinal Microbiome

重症肌无力(myasthenia gravis,MG)是一种由乙酰胆碱受体抗体介导、细胞免疫依赖、补体参与主要累及神经肌肉接头,引起其传递障碍,出现肌肉收缩无力的获得性自身免疫性疾病。人体肠道菌群是指存在于人体消化道中大量、多样的微生物种群,对人体的代谢、免疫稳态的发展和维持起着非常重要的作用,肠道菌群在自身免疫性疾病中的作用引起了越来越多学者的关注,其中已被证实的肠道菌群会影响的疾病有类风湿性关节炎和多发硬化症,也有学者猜测在重症肌无力的发病机制中肠道微生物群也起着关键作用。该文归纳总结了重症肌无力的发病机制、肠道菌群的免疫调节机制以及微生物-肠-脑轴的相互作用,认为T淋巴细胞的增殖与分化机制,以及肠道微生物群中不同菌群的变化是肠道菌群影响重症肌无力发病的关键环节。文章主要目的就是分析重症肌无力发病机制与肠道微生物群之间的关系,完善我们对这一领域的认识,为日后研究重症肌无力的发病机制和临床治疗提供新的思路。

Myasthenia gravis(MG)is an acquired autoimmune disease,which is mediated by acetylcholine receptor antibody,cell immune dependence and complement involvement,mainly involving neuromuscular junction,causing its transmission disorder and muscle contraction weakness.Human intestinal flora refers to a large number of diverse microbial populations in the human digestive tract,which plays a very important role in the development and maintenance of human metabolism and immune homeostasis.The role of intestinal flora in autoimmune diseases has attracted more and more attention.Among them,rheumatoid arthritis and multiple sclerosis have been confirmed to be affected by intestinal microflora.Some scholars speculate that intestinal microflora also plays a key role in the pathogenesis of myasthenia gravis.This paper summarizes the pathogenesis of myasthenia gravis,the immune regulation mechanism of intestinal microflora,and the interaction of microorganism gut brain axis.It is considered that the mechanism of T lymphocyte proliferation and differentiation and the changes of different intestinal microflora are the key links of intestinal microflora affecting the pathogenesis of myasthenia gravis.The main purpose of this review is to analyze the relationship between the pathogenesis of myasthenia gravis and intestinal microbiota,improve our understanding of this field,and provide new ideas for the future study of the pathogenesis and clinical treatment of myasthenia gravis.