Microorganisms in the Pathogenesis and Management of Spondyloarthritis

Abstract

AbstractSpondyloarthritis is an umbrella term for a group of inflammatory diseases of the joints and spine. The group includes ankylosing spondylitis, reactive arthritis, psoriatic arthritis, arthritis associated with inflammatory bowel disease, and undifferentiated spondyloarthritis. Although the etiology and pathogenesis of spondyloarthritis are still largely unknown, the clinical overlap and shared genetics between the different disease subtypes indicate the potential for a shared pathogenetic mechanism. Increasing evidence suggests that dysregulated host/enteric microbial interactions are commonly observed in spondyloarthritis and may be a requisite for disease development. This chapter reviews the available evidence supporting the notion that spondyloarthritis is a microbiome-driven disease and discusses how genetic, environmental, and microbiota-specific interactions may affect the host immune response and lead to inflammation and autoimmunity. The chapter further discusses how microbiome research may not only provide new insight into disease pathogenesis but may also revolutionize diagnosis, prognosis, and treatment of spondyloarthritis.KeywordsSpondyloarthropathyHLA-B27MicrobiomeDysbiosisInterleukin-23ERAP1COVID-19