The Intestinal Microbiome in Spondyloarthritis

Tejpal Gill; Mark Asquith; James T. Rosenbaum; Robert A. Colbert


Curr Opin Rheumatol. 2015;27(4):319-325. 

In This Article

Juvenile Spondyloarthritis

Patients with a form of juvenile SpA classified as enthesitis-related arthritis, exhibit decreased abundance of Clostridium leptum[53] similarly to AS patients.[47] Another member of the Clostridales family known as Fecalibacterium prausnitzii was also decreased in patients with juvenile SpA compared with healthy controls. Despite these differences, serum IgA and Immunoglobulin G (IgG) IgG antibody against F. prausnitzii and B. fragilis were similar between controls and patients. There is also some evidence of a cellular immune response to the outer membrane protein of Salmonella typhimurium in juvenile SpA patients compared with healthy controls.[54] Intriguingly, study of the microbiota of juvenile SpA patients revealed that patients could be stratified into two distinct clusters, one dominated by Bacteroides genus members, the other by Akkermansia muciniphila. The fact these may represent distinct disease subtypes remains an enticing possibility and serves to highlight that this approach may also be extended to the spectrum of SpA-like diseases.