Studies have shown that the intestinal microbiome can affect extra-intestinal sites such as joints, skin, and the body's immune response.1 Research has suggested that gut microbe composition plays a role in the pathogenesis of inflammatory diseases like spondyloarthritis (SpA), particularly in genetically susceptible persons, and may provide a novel strategy for treating and preventing various forms of arthritis and their associated comorbidities (such as inflammatory bowel disease [IBD]). However, studies evaluating the connection between SpA and the microbiome remain scarce, with much evidence coming from animal studies, small human studies, or studies of other inflammatory diseases.
Additionally, the methods used to evaluate the microbiome have varied across studies, making it difficult to compare results, but next-generation sequencing technologies promise to improve assessment of the human microbiome and enable identification of previously uncharted bacterial populations, potentially opening the door to a wider set of microbiome-directed treatments in the future.2
References
- Eppinga H, Konstantinov SR, Peppelenbosch MP, Thio HB. The microbiome and psoriatic arthritis. Curr Rheumatol Rep. 2014;16(3):407. doi: 10.1007/s11926-013-0407-2
- Gill T, Asquith M, Rosenbaum JT, Colbert RA. The intestinal microbiome in spondyloarthritis. Curr Opin Rheumatol. 2015;27(4):319-325. doi: 10.1097/BOR.0000000000000187
- Costello ME, Ciccia F, Willner D, et al. Intestinal dysbiosis in ankylosing spondylitis. Arthritis Rheumatol. 2014 Nov 21. doi: 10.1002/art.38967
- Stoll ML, Kumar R, Morrow CD, et al. Altered microbiota associated with abnormal humoral immune responses to commensal organisms in enthesitis-related arthritis. Arthritis Res Ther. 2014;16(6):486. doi: 10.1186/s13075-014-0486-0
- Scher JU, Ubeda C, Artacho A, et al. Decreased bacterial diversity characterizes the altered gut microbiota in patients with psoriatic arthritis, resembling dysbiosis in inflammatory bowel disease. Arthritis Rheumatol. 2015;67(1):128-139. doi: 10.1002/art.38892
- Gao Z, Tseng CH, Strober BE, Pei Z, Blaser MJ. Substantial alterations of the cutaneous bacterial biota in psoriatic lesions. PLoS One. 2008;3(7):e2719. doi: 10.1371/journal.pone.0002719
- Fahlén A, Engstrand L, Baker BS, Powles A, Fry L. Comparison of bacterial microbiota in skin biopsies from normal and psoriatic skin. Arch Dermatol Res. 2012;304(1):15-22. doi: 10.1007/s00403-011-1189-x
- Khan MT, Duncan SH, Stams AJM, et al. The gut anaerobe Faecalibacterium prausnitzii uses an extracellular electron shuttle to grow at oxic-anoxic interphases. The ISME Journal. 2012;6(8):1578-1585. doi: 10.1038/ismej.2012.5
- Castelino M, Eyre S, Upton M, Ho P, Barton A. The bacterial skin microbiome in psoriatic arthritis, an unexplored link in pathogenesis: challenges and opportunities offered by recent technological advances. Rheumatology (Oxford). 2014;53(5):777-784. doi: 10.1093/rheumatology/ket319
- Canadian Spondylitis Association. What is spondyloarthritis? http://www.spondylitis.ca/spondyloarthritis/what-is-spondyloarthritis/. Accessed November 29, 2016.
- Rosenbaum JT, Davey MP. Hypothesis: Time for a gut check: HLA B27 predisposes to ankylosing spondylitis by altering the microbiome. Arthritis and Rheumatism. 2011;63(11):3195-3198. doi:10.1002/art.30558
- Gill T, Asquith M, Rosenbaum JT, Colbert RA. The intestinal microbiome in spondyloarthritis. Curr Opin Rheumatol. 2015;27(4):319-325. doi: 10.1097/BOR.0000000000000187
- Scher JU, Littman DR, Abramson SB. Microbiome in inflammatory arthritis and human rheumatic diseases. Arthritis Rheumatol. 2016;68(1):35-45. doi: 10.1002/art.39259
- Inman RD. Mechanisms of disease: infection and spondyloarthritis. Nat Clin Pract Rheumatol. 2006;2(3):163-169. doi: 10.1038/ncprheum0118
- Ogrendik M. Treatment of ankylosing spondylitis with moxifloxacin. South Med J. 2007;100(4):366-370. doi: 10.1097/SMJ.0b013e31802fa2a8
- Jenks K, Stebbings S, Burton J, Schultz M, Herbison P, Highton J. Probiotic therapy for the treatment of spondyloarthritis: a randomized controlled trial. J Rheumatol. 2010;37(10):2118-2125. doi: 10.3899/jrheum.100193
- Vaghef-Mehrabany E, Alipour B, Homayouni-Rad A, Sharif SK, Asghari-Jafarabadi M, Zavvari S. Probiotic supplementation improves inflammatory status in patients with rheumatoid arthritis. Nutrition. 2014;30(4):430-435. doi:10.1016/j.nut.2013.09.007
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