肠骨轴在强直性脊柱炎发病机制中的调控作用及临床转化潜力
The Regulatory Role of the Gut-Bone Axis in the Pathogenesis of Ankylosing Spondylitis and Its Clinical Translational Potential
DOI: 10.12677/jcpm.2026.52102, PDF,   
作者: 章 杰*：赣南医科大学第一临床医学院，江西 赣州；李俊霖*：赣南医科大学基础医学院，江西 赣州；杨亚东#：赣南医科大学第一附属医院骨科，江西 赣州
关键词: 强直性脊柱炎(AS)；肠骨轴；肠道菌群；发病机制；炎症；成骨；钙化；Ankylosing Spondylitis (AS)； Gut-Bone Axis； Intestinal Flora； Pathogenesis； Inflammation； Osteogenesis； Calcification
摘要: 强直性脊柱炎(AS)是一种以脊柱及骶髂关节慢性炎症为特征的疾病，其发病机制至今尚未完全阐明。近年研究发现，肠道微生物群与骨骼系统之间的双向调控网络——即肠骨轴，可能通过免疫调节、代谢产物分泌及炎症通路激活等机制参与AS的病理成骨进程。尽管现有研究已证实肠骨轴与AS的关联性，但具体分子机制、微生物–宿主互作模式以及个体差异影响因素仍需深入探索。尤其是菌群代谢物(如丁酸盐)是否调控成骨细胞分化，以及肠道屏障破坏与脊柱强直之间的时空因果关系，仍是当前研究的核心未解问题。本文系统综述了肠骨轴在AS中的最新研究进展，重点解析微生物群–免疫–骨骼的交叉调控机制，并评估靶向干预策略(如益生菌疗法、饮食调控)的临床潜力。基于肠骨轴在AS中的重要性，我们提出多学科整合的研究框架，旨在为AS精准诊疗提供新靶点。
Abstract: Ankylosing Spondylitis (AS) is a disease characterized by chronic inflammation of the spine and sacroiliac joints. Its pathogenesis has not yet been fully elucidated. Recent studies have revealed that the bidirectional regulatory network between the intestinal microbiota and the skeletal system - namely the gut-skeletal axis-may participate in the pathological bone formation process of AS through mechanisms such as immune regulation, secretion of metabolites, and activation of inflammatory pathways. Although existing studies have confirmed the association between the gut-skeletal axis and AS, the specific molecular mechanisms, microbial-host interaction patterns, and factors influencing individual differences still need to be further explored. In particular, whether the metabolites of the microbiota (such as butyrate) regulate the differentiation of osteoblasts, and the temporal and spatial causal relationship between intestinal barrier disruption and spinal ankylosis, remain the core unresolved issues in current research. This article systematically reviews the latest research progress of the gut-skeletal axis in AS, focuses on analyzing the cross-regulatory mechanism of the microbiota-immune-skeleton, and assesses the clinical potential of targeted intervention strategies (such as probiotic therapy, dietary regulation). Based on the importance of the gut-skeletal axis in AS, we propose a multidisciplinary integrated research framework, aiming to provide new targets for the precise diagnosis and treatment of AS.
文章引用：章杰, 李俊霖, 杨亚东. 肠骨轴在强直性脊柱炎发病机制中的调控作用及临床转化潜力[J]. 临床个性化医学, 2026, 5(2): 68-78. https://doi.org/10.12677/jcpm.2026.52102

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