Subclinical gut inflammation in ankylosing spondylitis

Area of Science:

• Gastroenterology
• Immunology
• Rheumatology

Background:

• Subclinical gut inflammation is prevalent in ankylosing spondylitis (AS) patients, with some progressing to overt inflammatory bowel disease.
• The gut in AS is characterized by distinct histologic, immunologic, and intestinal microbiota alterations.

Purpose of the Study:

• To review the role of the gut in AS pathogenesis.
• To explore the connection between gut inflammation, microbial dysbiosis, and immune responses in AS.

Main Methods:

• Review of current literature on gut involvement in AS.
• Analysis of studies investigating histologic, immunologic, and microbiota changes in AS patients.

Main Results:

• AS patients exhibit gut microbial dysbiosis and altered innate immune responses.
• The gut contributes to AS pathogenesis via pro-inflammatory cytokines (e.g., IL-23p19) and pathogenic innate lymphoid cells (IL-22, IL-17).
• A significant correlation exists between subclinical gut inflammation and spinal inflammation severity in AS.

Conclusions:

• Subclinical gut inflammation and altered innate immunity in AS may stem from microbial dysbiosis.
• The precise causal relationship between gut changes and AS pathogenesis requires further investigation.