Published online Oct 18, 2025. doi: 10.5312/wjo.v16.i10.108374
Revised: May 28, 2025
Accepted: September 10, 2025
Published online: October 18, 2025
Processing time: 187 Days and 14.8 Hours
Spondyloarthritis (SpA), a prevalent chronic inflammatory disorder, predominantly impacts the axial skeleton, including the spine and sacroiliac joints. Emerging evidence implicates gut dysbiosis in the pathogenesis of SpA.
To evaluate the association between gut microbiome alterations and SpA through metagenomic sequencing analyses.
A systematic review was conducted by querying English-language databases, including PubMed, EMBASE, and Google Scholar, spanning 2000 to 2023. From an initial pool of 150 studies, four articles meeting stringent inclusion and exclusion criteria were selected for analysis.
The reviewed studies identified an enrichment of opportunistic pathogenic bacterial species, such as Clostridium spp., Prevotella spp., and Bacteroides spp., alongside viral families including Gratiaviridae and Quimbyviridae, in individuals with ankylosing spondylitis compared to healthy controls. Dysregulated metabolic pathways were highlighted as potential mediators of chronic inflammation and arthritic manifestations. Notably, treatment with tumor necrosis factor inhibitors demonstrated efficacy in mitigating SpA symptoms and restoring gut microbial balance.
The findings underscore a significant presence of pathogenic gut microbiota in SpA patients, suggesting a pivotal role in disease progression. Future investigations should focus on species-specific microbial targets to develop innovative therapies for preventing and managing SpA and associated gut dysbiosis.
Core Tip: Spondyloarthritis (SpA) is a chronic inflammatory condition impacting the axial skeleton, with emerging links to gut microbiome dysbiosis. A systematic review highlights enrichment of pathogenic bacterial and viral species in SpA patients, suggesting gut microbes contribute to disease progression. Dysregulated metabolic pathways may mediate inflammation, while tumor necrosis factor inhibitors show promise in symptom relief and microbial balance restoration. Targeting specific microbial species may unlock innovative therapies for SpA management and gut dysbiosis prevention.