Subclinical gut inflammation in ankylosing spondylitis

Curr Opin Rheumatol. 2016 Jan;28(1):89-96. doi: 10.1097/BOR.0000000000000239.

Abstract

Purpose of review: Subclinical gut inflammation has been described in a significant proportion of patients with ankylosing spondylitis (AS), up to 10% of them developing it during the time of clinically overt inflammatory bowel disease. Histologic, immunologic, and intestinal microbiota alterations characterize the AS gut.

Recent findings: Microbial dysbiosis as well as alterations of innate immune responses have been demonstrated in the gut of AS. Furthermore, a growing body of evidence suggests that the gut of AS patients may be actively involved in the pathogenesis of AS through the production of proinflammatory cytokines, such as IL-23p19, and the differentiation of potentially pathogenic innate lymphoid cells producing IL-22 and IL-17. Finally, a strong correlation between the presence of subclinical gut inflammation and the degree of spine inflammation have been also proved in AS.

Summary: Subclinical gut inflammation and innate immune responses in AS may be considered a possible consequence of microbial dysbiosis. Relationships between cause and effect remain, however, to be answered.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adaptive Immunity
  • Animals
  • Cytokines / biosynthesis
  • Disease Models, Animal
  • Dysbiosis / immunology
  • Gastrointestinal Microbiome / immunology
  • Humans
  • Immunity, Innate
  • Inflammation / immunology
  • Inflammatory Bowel Diseases / immunology*
  • Inflammatory Bowel Diseases / pathology
  • Intestines / immunology
  • Intestines / pathology
  • Macrophages / immunology
  • Mice
  • Spondylitis, Ankylosing / complications
  • Spondylitis, Ankylosing / immunology*

Substances

  • Cytokines