ArticleArthritis research & therapy2022
Gut dysbiosis associated with worse disease activity and physical function in axial spondyloarthritis.
Article in Arthritis research & therapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Frequency of irritable bowel syndrome in spondyloarthritis: a multicentric cross-sectional study and meta-analysis.RMD open · 2024Pooled it
- Towards standardized gut microbiota diagnostics: normobiosis beyond geographical borders.Gut microbes · 2026Article
- Faecal calprotectin for the diagnosis of bowel inflammation in patients with rheumatologic diseases: what is new in the last 5 years (2020-2025)?EULAR rheumatology open · 2026Article
- Oral microbiota alterations in radiographic axial spondyloarthritis.Frontiers in medicine · 2026Article
- Multi-omics insights into spondyloarthritis and psoriatic arthritis: integrating genomics, transcriptomics, proteomics, and the microbiome for immunological and clinical translation.Frontiers in immunology · 2026Review
- Alterations in the Gut Microbiome in Ankylosing Spondylitis and Their Correlation with Disease Activity.Journal of microbiology and biotechnology · 2025Article
- Proinflammatory macrophages transporting gut-derived bacterial DNA drive autoimmune arthritis in spondyloarthropathy.JCI insight · 2025Article
- Gut expression of CD71 and co-localisation with Dec-1 associated with high levels of serum SIgA and disease activity in SpA.Scientific reports · 2025Article
- Role of microbiota in pain: From bench to bedside.iMetaOmics · 2025Review
- Gut microbiota and ankylosing spondylitis: current insights and future challenges.Microbial cell (Graz, Austria) · 2025Review
- The failure of biological treatment in axial spondyloarthritis is linked to the factors related to increased intestinal permeability and dysbiosis: prospective observational cohort study.Rheumatology international · 2024Observational
- Dysbiosis in Inflammatory Bowel Disease and Spondyloarthritis: Still a Long Way to Go?Journal of clinical medicine · 2024Review
- Clinical features and fecal microbiota characteristics of patients with both ulcerative colitis and axial spondyloarthritis.BMC gastroenterology · 2024Article
- Beyond the horizon: Innovations and future directions in axial-spondyloarthritis.Archives of rheumatology · 2023Review
- Differential gut microbiome in spondyloarthritis patients associated to Blastocystis colonization.Scientific reports · 2023Article
- Are Patients with Axial Spondyloarthritis Who Were Breastfed Protected against the Development of Severe Disease?Journal of clinical medicine · 2023Article
- Practical Significance of Biomarkers in Axial Spondyloarthritis: Updates on Diagnosis, Disease Activity, and Prognosis.International journal of molecular sciences · 2022Review
- Inflammatory Bowel Disease: Focus on Enteropathic Arthritis and Therapy.Rheumatology and immunology research · 2022Review
- Axial spondyloarthritis patients have altered mucosal IgA response to oral and fecal microbiota.Frontiers in immunology · 2022Article
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Authors and funding
9 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBased on clinical and genetic associations, axial spondyloarthritis (axSpA) and inflammatory bowel disease (IBD) are suspected to have a linked pathogenesis. Gut dysbiosis, intrinsic to IBD, has also been observed in axSpA. It is, however, not established to what degree gut dysbiosis is associated with axSpA disease severity. The objective of this study was to compare gut dysbiosis frequency between controls, non-radiographic axial spondyloarthritis (nr-axSpA), and ankylosing spondylitis (AS) patients and investigate whether gut dysbiosis is cross-sectionally associated with axSpA disease activity, physical function, mobility, or pain.
methodsGut dysbiosis was assessed by 16SrRNA analysis of feces from 44/88 nr-axSpA/AS patients (ASAS/mNY criteria) without inflammatory bowel disease (IBD) and 46 controls without IBD or rheumatic disease. The GA-map™ Dysbiosis Test was used, grading gut microbiota aberrations on a 1-5 scale, where ≥3 denotes dysbiosis. Proportions with dysbiosis were compared between the groups. Furthermore, standard axSpA measures of disease activity, function, mobility, and pain were compared between patients (nr-axSpA and AS combined) with and without dysbiosis, univariately, and adjusted for relevant confounders (ANCOVA).
resultsGut dysbiosis was more frequent in AS than controls (36% versus 17%, p=0.023), while nr-axSpA (25% dysbiosis) did not differ significantly from either AS or controls. Univariately, most axSpA measures were significantly worse in patients with dysbiosis versus those without: ASDAS-CRP between-group difference 0.6 (95% CI 0.2-0.9); BASDAI 1.6 (0.8-2.4); evaluator's global disease activity assessment (Likert scale 0-4) 0.3 (0.1-0.5), BASFI 1.5 (0.6-2.4), and VAS pain (cm) 1.3 (0.4-2.2). Differences remained significant after adjustment for demographics, lifestyle factors, treatments, gut inflammation (fecal calprotectin ≥50 mg/kg), and gut symptoms, except for VAS pain. BASMI and CRP were not associated with dysbiosis.
conclusionGut dysbiosis, more frequent in AS patients than controls, is associated with worse axSpA disease activity and physical function, seemingly irrespective of both gut inflammation and treatments. This provides further evidence for an important link between disturbances in gastrointestinal homeostasis and axSpA.
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