Spondyloarthritis and the microbiota: Where are we now?

Spondyloarthritis (SpA) is now classified as a spectrum of disorders, with two major subtypes: axial SpA (axSpA) and peripheral SpA (pSpA). AxSpA can be further divided into radiographic axSpA (ankylosing spondylitis) and non-radiographic axSpA. Other subtypes include axial psoriatic arthritis, axial reactive arthritis, and inflammatory bowel diseases associated with SpA. The dysbiosis of the microbiota, or the gut-joint axis, has been identified as a potential mechanism in the pathogenesis of SpA. Studies have shown inconsistent results regarding the specific bacteria involved, but some have been associated with increased gut permeability and inflammation. The skin microbiome has also been implicated in PsA, a subtype of SpA. Treatment options for SpA include non-pharmacological methods, NSAIDs, csDMARDs, bDMARDs, and tsDMARDs. The microbiota may also affect the response to these treatments, and probiotics have shown some promise in improving symptoms. However, more research is needed to fully understand the role of the microbiota in SpA and to develop targeted treatments. [Extracted from the article]