Response to: 'Microbiome in Sjögren's syndrome: here we are' by van der Meulen et al.
Response to: 'Microbiome in Sjögren's syndrome: here we are' by van der Meulen et al.
复制标题
回应：van der Meulen 等人的“干燥综合征中的微生物组：我们在这里”。
DOI：
10.1136/annrheumdis-2020-218327
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发表时间：
2022
影响因子：
27.4
通讯作者：
Scher,JoseU
中科院分区：
文献类型：
--
作者：
Manasson,Julia;Blank,RebeccaB;Scher,JoseU
我们要感谢 van der Meulen 等人对我们的综述的兴趣以及他们对微生物组在干燥综合征 (SS) 中的作用的评论。 1 2 正如他们正确指出的那样，我们的评论中没有提及 SS，主要是因为我们与编辑一起决定将研究最多的风湿病和自身免疫性疾病纳入其中，因为它们与微生物组研究有关。我们同意 SS 是一种常见疾病，其发病机制令人着迷但尚未完全阐明，并且在这种情况下微生物组的表征确实值得研究。我们还注意到，我们的评论中提到的疾病实体是当前在该领域进行的研究类型的示例。本综述的目的是概述能够使微生物组研究超越相关研究设计并进入机械方法领域的技术和策略，无论疾病的进程如何，这些方法可能与临床实践具有更大的相关性。尽管 van der Meulen 等人参考了 SS 中有价值的研究，但我们强调这样一个事实，即其中许多研究基于相对较小的样本量得出结论，仅依赖于范围有限的 16S rRNA 测序，更重要的是，它们本质上是相关的，这限制其在临床实践中的应用。 3-11 正如我们在评论中所述，为了让微生物组研究进一步了解自身免疫性疾病发病机制、对患者进行分层并导致个性化治疗的应用，该领域必须采用最先进的方法，12 旨在研究机制而不是相关性，并允许数据验证和数据共享。我们进一步同意 van der Meulen 等人的观点，即微生物组研究不应仅限于肠道，介入研究可能具有临床影响。事实上，这两点都在我们的手稿中进行了讨论（参见“导航和应对微生物组研究的挑战”和“未来会怎样”部分）。作者关于一次应研究一种以上风湿性疾病的建议很有趣，但需要谨慎进行，因为即使是单一风湿性疾病（例如，系统性红斑狼疮 13 或银屑病关节炎 14）也存在异质性。一次探索多种疾病会引入额外的变量，从而可能难以解释结果。我们感谢 van der Meulen 等人提出的额外注意事项。尽管我们已经为未来研究在这一流体学科的背景下应该努力的方向建立了一个框架，但微生物组研究当然还有其他警告没有涵盖在我们的审查范围内。
We would like to thank van der Meulen et al for their interest in our review and their comments regarding the role of the microbiome in Sjogren’s syndrome (SS). 1 2 As they correctly point out, SS was not mentioned in our review primarily because we, along with the editors, have decided to include the most studied rheumatic and autoimmune conditions as they pertain to microbiome research. We agree that SS is a common disorder with an intriguing and yet to be fully elucidated etiopathogenesis, and that the characterisation of the microbiome in this context is indeed worth pursuing. We also note that the disease entities mentioned in our review were meant as examples of the types of studies currently being performed in the field. The purpose of the review is to outline techniques and strategies that can move microbiome research beyond correlative study designs and into the realm of mechanistic approaches that may have significantly more relevance to clinical practice irrespective of the disease process.Although van der Meulen, et al reference valuable studies in SS, we underscore the fact that many of them draw conclusions based on relatively small sample sizes, rely solely on 16S rRNA sequencing, which is limited in scope, and more importantly, are correlative in nature, which restrict their application to clinical practice. 3–11 As we state in our review, in order for microbiome research to further the understanding of autoimmune disease pathogenesis, stratify patients and lead to the application of personalised therapies, the field must adopt state-of-the-art methods, 12 aim to study mechanisms rather than correlations, and allow for data validation and data sharing. We further agree with van der Meulen et al that microbiome studies should not be restricted to the gut and that interventional studies may be clinically impactful. In fact, both of these points were discussed in our manuscript (see sections on ‘Navigating and addressing challenges in microbiome research’and ‘What the future holds ‘). The authors’ suggestion that more than one rheumatic disease should be studied at a time is interesting, but would need to be pursued cautiously as there is established heterogeneity within even a single rheumatic disease (eg, systemic lupus erythematosus 13 or psoriatic arthritis 14). Exploring multiple diseases at a time would introduce additional variables, making it potentially difficult to interpret outcomes. We appreciate the extra dos and don’ts put forward by van der Meulen, et al. There are certainly other caveats to microbiome research not covered within the scope of our review, though we have set up a framework for what future studies should strive for in the context of this fluid discipline.