What is the role of gut microbiome alterations in the pathophysiology of relapsing polychondritis (RP)?

Updated: Dec 24, 2020
  • Author: Nicholas Compton, MD; Chief Editor: Herbert S Diamond, MD  more...
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Shimizu et al propose that the pathogenesis of relapsing polychondritis may involve alteration of gut microbiota. Their study found that the gut microbiome in patients with relapsing polychondritis contains higher numbers of microbes that produce propionate, which is a short-chain fatty acid that may affect interleukin-10 (IL-10)–producing regulatory T (Treg) cell differentiation in gut-associated lymphoid tissues. [24]

These authors suggest that in relapsing polychondritis, continuous stimulation of intestinal T cells by excessive propionate leads to the spontaneous production of IL-10 and a subsequent refractory period of T cells. In turn, hyporesponsiveness of Treg cells upon activation may associate with production by PBMC and subsequent chondritis. [24]  

our findings suggested that propionate-producing gut microbes became predominant, leading to defective Treg cell function upon activation in patients with RP. Decreased production of IL10 by Treg cells and increased production of the inflammatory cytokine tumor necrosis factor–α   TNFα by  PBMC may lead to chondritis in patients with relapsing polychondritis. [24]

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