Gut microbiota changes in patients with spondyloarthritis: A systematic review

Lei Wang; Yiwen Wang; Pei Zhang; Chuan Song; Fei Pan; Gang Li; Lihua Peng; Yunsheng Yang; Zhimin Wei; Feng Huang

doi:10.1016/j.semarthrit.2021.11.002

Gut microbiota changes in patients with spondyloarthritis: A systematic review

Semin Arthritis Rheum. 2022 Feb:52:151925. doi: 10.1016/j.semarthrit.2021.11.002. Epub 2021 Nov 15.

Authors

Lei Wang¹, Yiwen Wang², Pei Zhang³, Chuan Song¹, Fei Pan⁴, Gang Li⁵, Lihua Peng⁴, Yunsheng Yang⁴, Zhimin Wei⁶, Feng Huang⁷

Affiliations

¹ Department of Rheumatology and Immunology, The First Medical Center, Chinese PLA General Hospital, Beijing, China; Medical School of Chinese PLA, Beijing, China.
² Department of Rheumatology and Immunology, The First Medical Center, Chinese PLA General Hospital, Beijing, China.
³ School of Medicine, Nankai University, Tianjin, China.
⁴ Department of Gastroenterology and Hepatology, The First Medical Center, Chinese PLA General Hospital, Beijing, China.
⁵ Health Service Department of the Guard Bureau of the Joint Staff Department, Beijing, China.
⁶ Health Service Department of the Guard Bureau of the Joint Staff Department, Beijing, China. Electronic address: 51807124@qq.com.
⁷ Department of Rheumatology and Immunology, The First Medical Center, Chinese PLA General Hospital, Beijing, China. Electronic address: fhuang@301hospital.com.cn.

PMID: 34844732
DOI: 10.1016/j.semarthrit.2021.11.002

Abstract

Objective: Gut microbiota has been proposed as a pivotal role in the progression of Spondyloarthritis (SpA), however diverse results remain to be synthesized. We performed a systematic review to collect evidence on the characteristic of the gut microbiota in patients with SpA, as compared to controls.

Methods: We systematically searched MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials databases, through June 1, 2021 for studies that compared gut microbiota of cases with SpA versus healthy controls.

Results: Of 3756 records identified, 28 studies from 23 articles were included in the analysis. Results of β-diversity showed SpA patients hold a significantly different microbial composition compared with controls. Several taxa-level differences of gut microbiota between SpA (and its subtypes) cases and controls were identified. Fourteen studies including only patients with ankylosing spondylitis (AS) reported increased amounts of Actinobacteria, Dialister, Streptococcus, and Clostridium bolteae, and decreased amounts of Bacteroidales and Parasutterella in AS cases versus controls in ≥ 3 studies. Dialister invisus was increased in axial-SpA cases versus controls in 3 studies. Bacteroides fragilis was increased in enthesitis-related arthritis (ERA) cases versus controls in 2 studies. For all SpA studies, Proteobacteria, Enterobacteriaceae, and Bacteroidaceae were increased, whereas Bacteroidetes, Bacteroidales, and Akkermansia were decreased in cases versus controls in ≥ 3 studies. Over 40% of the studies showed comparable data of both sex and age between cases and controls.

Conclusion: The microbial characteristics of SpA summarized in the systematic review laid the groundwork for evidence-based microbial treatment. The microbial variance among subtypes of SpA remains to be explored. Further studies are needed to elucidate how the altered microbiota participate in the pathogenesis of SpA.

Keywords: Ankylosing spondylitis; Enthesitis-related arthritis; Gut microbiota; Microbiome; Spondyloarthritis.

Publication types

Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Arthritis, Juvenile*
Gastrointestinal Microbiome*
Humans
Spondylarthritis* / microbiology
Spondylitis, Ankylosing*