Table_3_Metabolomic analysis in spondyloarthritis: A systematic review.DOCX

Spondyloarthritis (SpA) is a group of rheumatic diseases that cause joint inflammation. Accumulating studies have focused on the metabolomic profiling of SpA in recent years. We conducted a systematic review to provide a collective summary of previous findings on metabolomic profiling associated with SpA. We systematically searched PubMed, Medline, Embase and Web of Science for studies on comparisons of the metabolomic analysis of SpA patients and non-SpA controls. The Newcastle–Ottawa Scale (NOS) was used to assess the quality of the included articles. From 482 records identified, 31 studies were included in the analysis. A number of metabolites were differentially distributed between SpA and non-SpA cases. SpA patients showed higher levels of glucose, succinic acid, malic acid and lactate in carbohydrate metabolism, higher glycerol levels and lower fatty acid (especially unsaturated fatty acid) levels in lipid metabolism, and lower levels of tryptophan and glutamine in amino acid metabolism than healthy controls. Both conventional and biological therapy of SpA can insufficiently reverse the aberrant metabolism state toward that of the controls. However, the differences in the results of metabolic profiling between patients with SpA and other inflammatory diseases as well as among patients with several subtypes of SpA are inconsistent across studies. Studies on metabolomics have provided insights into etiological factors and biomarkers for SpA. Supplementation with the metabolites that exhibit decreased levels, such as short-chain fatty acids (SCFAs), has good treatment prospects for modulating immunity. Further studies are needed to elucidate the role of disordered metabolic molecules in the pathogenesis of SpA.

脊柱关节炎（Spondyloarthritis, SpA）是一类引发关节炎症的风湿性疾病。近年来，越来越多的研究聚焦于脊柱关节炎的代谢组学特征分析。本研究开展了一项系统综述，旨在系统性总结当前与脊柱关节炎相关的代谢组学分析研究成果。研究系统检索了PubMed、Medline、Embase及Web of Science数据库，筛选比较脊柱关节炎患者与非脊柱关节炎对照人群代谢组学分析的相关研究，并采用纽卡斯尔-渥太华量表（Newcastle–Ottawa Scale, NOS）对纳入文献的质量进行评估。初检共检索到482条记录，最终纳入31项研究进行分析。多项代谢物在脊柱关节炎患者与非脊柱关节炎对照人群中呈现差异分布。与健康对照相比，脊柱关节炎患者糖代谢通路中的葡萄糖、琥珀酸、苹果酸及乳酸水平显著升高；脂代谢通路中甘油水平升高，而脂肪酸（尤其是不饱和脂肪酸）水平降低；氨基酸代谢通路中的色氨酸与谷氨酰胺水平显著降低。脊柱关节炎的常规治疗与生物制剂治疗均无法完全将异常的代谢状态逆转至健康对照水平。然而，不同研究中脊柱关节炎患者与其他炎症性疾病患者的代谢组学特征差异，以及脊柱关节炎多种亚型患者间的代谢组学特征差异，结果并不一致。代谢组学研究为阐明脊柱关节炎的病因学因素及生物标志物提供了新的视角。补充表达水平下调的代谢物（如短链脂肪酸（short-chain fatty acids, SCFAs））在免疫调节方面具有良好的治疗前景。未来仍需开展更多研究，以阐明代谢紊乱分子在脊柱关节炎发病机制中的具体作用。