Gut microbiota and ankylosing spondylitis: current insights and future challenges

Area of Science:

• Immunology
• Microbiology
• Rheumatology

Background:

• Ankylosing spondylitis (AS) is a chronic inflammatory condition with complex origins.
• Growing evidence implicates the gut microbiota in AS pathogenesis.
• Gut dysbiosis may trigger or worsen AS through immune dysregulation and intestinal barrier dysfunction.

Purpose of the Study:

• To review the significant role of gut microbiota in ankylosing spondylitis.
• To explore how gut microbiota alterations influence AS onset and progression.
• To discuss the potential of targeting gut microbiota for novel AS therapies.

Main Methods:

• Literature review of recent studies on gut microbiota and AS.
• Analysis of the interplay between gut dysbiosis, immune responses (IL-23/17 axis), and AS.
• Examination of microbial mechanisms, including HLA-B27 interactions and molecular mimicry.

Main Results:

• Gut dysbiosis is a key factor in AS, influencing immune regulation via the IL-23/17 pathway.
• Altered gut microbiota and its metabolites contribute to systemic inflammation and the gut-joint inflammation cycle.
• Microbial factors may promote AS through HLA-B27 misfolding, endoplasmic reticulum stress, and molecular mimicry.

Conclusions:

• Targeting gut microbiota imbalances presents a promising therapeutic avenue for AS.
• An ongoing cycle of autoimmune inflammation involving the gut and joints is suggested in AS.
• Further longitudinal research is needed to fully elucidate the gut-joint axis in AS management.