Ankylosing spondylitis and microbiota: pathophysiology and clinical perspectives

Eremenko I. I.

Ankylosing spondylitis (AS, Bechterew disease, Struempel-Marie-Bechterew disease) is one of the common seronegative spondyloarthropathy with unclear etiology and complex pathogenesis. Studies of the role of microbiota in the pathophysiology of AS suggest an important role of dysbiosis, chronic intestinal inflammation and increased permeability of the intestinal wall in the occurrence, activity and rate of progression of AS. According to the "gut" theory, a vicious circle, triggered by dysbiosis of intestinal microbiota, which causes chronic inflammation of the intestinal wall, local and systemic dysregulation of the immune response, is recognized as a key mechanism initiating the development of AS. The elucidation of detailed mechanisms of the indicated interactions and search for effective therapies aimed at restoration of intestinal microbiota and intestinal wall integrity will allow to create a new direction for AS prevention and therapy in future. The purpose of this review is a detailed study of the most reliable experimental and clinical works devoted to pathophysiological interrelations between intestinal microbiota and AS. The review is based on articles published mainly between 2016 and 2022 in PubMed, Scopus, Web of Science and in peer-reviewed Russian journals.

Keywords:ankylosing spondylitis, microbiota, rheumatology