• Heleen CypersEmail author
  • S. Louis BridgesJr.
  • Dirk Elewaut


Spondyloarthritis (SpA) indicates a group of clinically and genetically related disorders characterized by chronic inflammation of the axial skeleton (sacroiliitis and spondylitis), the peripheral joints, and/or the entheses. SpA comprises different subtypes, including ankylosing spondylitis (AS), psoriatic arthritis (PsA), juvenile-onset SpA (enthesitis-related arthritis, ERA), reactive arthritis (ReA), and inflammatory bowel disease (IBD)-related arthritis. Convincing evidence has emerged for implicating the intestinal microbiota in SpA pathogenesis. This hypothesis is supported by clinical data, such as the triggering of reactive arthritis by gastrointestinal infections, the close relationship between gut and joint inflammation in SpA, and the overlap between SpA and IBD. In addition, genetic susceptibility factors linked with SpA might affect the response to microorganisms. Most compellingly, in certain animal models for SpA, disease does not develop in germ-free conditions. This chapter provides an overview of microbiota analyses performed in SpA patients, of underlying immunological mechanisms, and of possible therapeutic implications. The main focus will be on ankylosing spondylitis/axial SpA, as ReA, PsA, and ERA are covered elsewhere in this book.


HLA-B27 Microbiota Pattern recognition receptor Spondyloarthritis 



Ankylosing enthesopathy mouse model


Ankylosing spondylitis


Anti-saccharomyces antibody


Ankylosing spondylitis disease activity scale


Autophagy-related 16-like 1


Crohn’s disease


Cytotoxic T lymphocyte antigen 4


Dendritic cell


Denaturing gradient gel electrophoresis


Endoplasmic reticulum


Enthesitis-related arthritis


Endoplasmic receptor aminopeptidase


Fluorescent in situ hybridization


Fecal microbial transplantation


Human leukocyte antigen


Inflammatory bowel disease




Interleukin 23 receptor


Innate lymphoid cell




Mucosal-associated invariant T (cell)


Major histocompatibility complex


Modified New York


Magnetic resonance imaging


Nuclear factor-κB


Nucleotide oligomerization domain


Non-radiographic axial spondyloarthritis


Outer membrane protein


Pathogen-associated molecular pattern


Peripheral antineutrophil cytoplasmic antibody


Peripheral blood mononuclear cell


Pattern recognition receptor


Psoriatic arthritis


Rheumatoid arthritis


Reactive arthritis


Ribosomal ribonucleic acid


Short-chain fatty acids


Synovial fluid


Segmented filamentous bacteria


Synovial fluid mononuclear cell


Secretory immunoglobulin A




Specific pathogen-free




Signal transducer and activator of transcription 3


Transforming growth factor


Toll-like receptor


Regulatory T cell


Unfolded protein response


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Heleen Cypers
    • 1
    Email author
  • S. Louis BridgesJr.
    • 2
  • Dirk Elewaut
    • 1
    • 3
  1. 1.Department of RheumatologyGhent University HospitalGhentBelgium
  2. 2.Division of Clinical Immunology and Rheumatology, Comprehensive Arthritis, Musculoskeletal, Bone and Autoimmunity CenterUniversity of Alabama at BirminghamBirminghamUSA
  3. 3.Unit for Molecular Immunology and Inflammation, VIB Inflammation Research CenterGhent UniversityGhentBelgium

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