Does the microbiome play a causal role in spondyloarthritis?

Clin Rheumatol. 2014 Jun;33(6):763-7. doi: 10.1007/s10067-014-2664-5. Epub 2014 May 10.


The purpose of this study is to review the potential causal role of the microbiome in the pathogenesis of spondyloarthritis. The method used for the study is literature review. The microbiome plays a major role in educating the immune response. The microbiome is strongly implicated in inflammatory bowel disease which has clinical and genetic overlap with spondyloarthritis. The microbiome also plays a causal role in bowel and joint disease in HLA B27/human beta 2 microglobulin transgenic rats. The mechanism(s) by which HLA B27 could influence the microbiome is unknown but theories include an immune response gene selectivity, an effect on dendritic cell function, or a mucosal immunodeficiency. Bacteria are strongly implicated in the pathogenesis of spondyloarthritis. Studies to understand how HLA B27 affects bacterial ecosystems should be encouraged.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Animals, Genetically Modified
  • HLA-B27 Antigen / physiology
  • Humans
  • Immune System
  • Inflammatory Bowel Diseases / microbiology
  • Joint Diseases / microbiology
  • Microbiota*
  • Rats
  • Spondylarthritis / complications
  • Spondylarthritis / microbiology*


  • HLA-B27 Antigen