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Nat. Rev. Rheumatol. doi:10.1038/nrrheum.2016.68 Figure 1 Immune and disease-modulating capabilities of intestinal microbial metabolites and probiotics Figure 1 | Immune and disease-modulating capabilities of intestinal microbial metabolites and probiotics. The intestinal microbiota converts dietary fibres into short-chain and medium-chain fatty acids (SCFAs and MCFAs), primary bile acids into secondary bile acids, and choline derivates into trimethylamine (TMA). SCFAs act through various G protein-coupled receptors (GPCRs) to inhibit histone deacetylases (HDACs) and alter the biology of regulatory T (TREG) cells and dendritic cells or to activate the inflammasome. Secondary bile acids activate the transmembrane GPCR TGR5 and the farnesoid X receptor (FXR), inducing the T3 thyroid hormone and fibroblast growth factor 19 (FGF19), respectively. These pathways and end products modulate a variety of inflammatory, metabolic and autoimmune diseases. Probiotics support the host's immune system, enhance intestinal barrier function and limit enteric pathogens. The dark blue colour boxes highlight rheumatic diseases that might be affected by the intestinal microbiota. These diseases include gout, psoriatic arthritis (PsA), rheumatoid arthritis (RA) and osteoarthritis (OA). NASH, nonalcoholic steatohepatitis; PPARγ, peroxisome proliferator-activated receptor γ; SRA-1, scavenger receptor A-1; TMAO, TMA N-oxide. Abdollahi-Roodsaz, S. et al. (2016) The metabolic role of the gut microbiota in health and rheumatic disease: mechanisms and interventions Nat. Rev. Rheumatol. doi:10.1038/nrrheum.2016.68