The role of the gut and microbes in the pathogenesis of spondyloarthritis

Mark Asquith, Dirk Elewaut, Phoebe Lin, James T. Rosenbaum

Research output: Contribution to journalReview articlepeer-review

81 Scopus citations


The intestinal microbiota is firmly implicated not only in the pathogenesis of inflammatory bowel disease (IBD) but increasingly also in the development of inflammation at extraintestinal tissue sites. Significant clinical, genetic, immunological, and microbiological overlap exists between IBD and spondyloarthritis (SpA), which indicates that pathophysiological mechanisms are shared between these diseases and may center on the intestinal microbiota. Recently, culture-independent techniques have enabled the microbiota in health and disease to be described in increasing detail. Moreover, functional studies have identified myriad host effector and regulatory pathways that shape or are shaped by this microbial community. We consider the complex relationship between SpA pathogenesis and gut microbes, with a discussion of how manipulation of the gut microbiota itself may be a promising future target for SpA therapy.

Original languageEnglish (US)
Pages (from-to)687-702
Number of pages16
JournalBest Practice and Research: Clinical Rheumatology
Issue number5
StatePublished - 2014
Externally publishedYes


  • Ankylosing spondylitis
  • Dysbiosis
  • Inflammatory bowel disease
  • Microbiota
  • Reactive arthritis
  • Spondyloarthritis

ASJC Scopus subject areas

  • Rheumatology


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