Gut microbiome dysbiosis in uveitis - mechanistic insights and emerging therapeutic strategies.

Recent studies have suggested the existence of a gut-eye axis, thus bringing the role of gut microbiota (GM) in the development of ocular inflammation in uveitis into focus. The proposed mechanisms for GM dysbiosis-induced uveitis include molecular mimicry, increased intestinal permeability by disruption of barrier integrity, immunomodulation, and alterations. Data from observational clinical studies indicate distinctive microbial signatures associated with uveal inflammation. Based on these findings, novel therapeutic modalities targeting the GM, such as antibiotics, probiotics, prebiotics, fecal microbiota transplantation, biologics, and dietary interventions have been proposed. While initial studies have shown promising results, there is limited clinical evidence supporting their therapeutic efficiency in the management of uveitis. The complexity and diversity of the GM, along with the lack of controlled clinical trials pose a significant challenge to the development of targeted therapeutics. Additionally, further studies are needed to elucidate the molecular mechanisms linking GM dysbiosis and ocular inflammation for developing specific biomarkers for diagnosis, as well as personalized GM-targeted patient interventions.