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Journal of Translational Medicine

, 14:233

Immunobiology andimmunotherapy


BackgroundOnly recently, the scientific community gained insights on the importance of the intestinal resident flora for the host’s health and disease. Gut microbiota in fact plays a crucial role in modulating innate and acquired immune responses and thus interferes with the fragile balance inflammation versus tolerance.

Main bodyCorrelations between gut bacteria composition and the severity of inflammation have been studied in inflammatory bowel diseases. More recently similar alterations in the gut microbiota have been reported in patients with spondyloarthritis, whereas in rheumatoid arthritis an accumulating body of evidence evokes a pathogenic role for the altered oral microbiota in disease development and course. In the context of dysbiosis it is also important to remember that different environmental factors like stress, smoke and dietary components can induce strong bacterial changes and consequent exposure of the intestinal epithelium to a variety of different metabolites, many of which have an unknown function. In this perspective, and in complex disorders like autoimmune diseases, not only the genetic makeup, sex and immunologic context of the individual but also the structure of his microbial community should be taken into account.

ConclusionsHere we provide a review of the role of the microbiota in the onset, severity and progression of chronic inflammatory arthritis as well as its impact on the therapeutic management of these patients. Furthermore we point-out the complex interwoven link between gut-joint-brain and immune system by reviewing the most recent data on the literature on the importance of environmental factors such as diet, smoke and stress.

KeywordsMicrobiota Chronic inflammatory arthritis Immunosuppressant Probiotic Stress Diet Smoke AbbreviationsSpAspondyloarthritis

RArheumatoid arthritis

eRAearly rheumatoid arthritis

ILFisolated lymphoid follicles

SFBsegmented filamentous bacteria

Tregregulatory T

Tfhfollicular T helper

SCFAsshort-chain fatty acids

MHCmajor histocompatibility complex

ASankylosing spondylitis

PsApsoriatic arthritis

TLRtoll like receptors

CARD9caspase recruitment domain-containing 9

IBDinflammatory bowel disease

ANKENTankylosing enthesopathy mouse

PBMCperipheral blood mononuclear cells

ACPAsanti-citrullinated protein antibodies

MGWASmetagenome-wide association study


AIAAg-induced arthritis


DMARDsdisease modifying antirheumatic drugs

RCTsrandomized clinical trials

PUFAfatty acid

ARAarachidonic acid

EPAeicosapentaenoic acid

DHAdocosahexaenoic acid

CRPC reactive protein

DAS28disease activity score on 28 joints

BASDAIbath ankylosing disease activity index

UCulcerative colitis

BASFIbath ankylosing functional index

MASESmaastricht spondylitis enthesitis score

JIAjuvenile idiopatihc arthritis


CDcrohn disease

Andrea Picchianti Diamanti and M. Manuela Rosado contributed equally to this work

Author: Andrea Picchianti Diamanti - M. Manuela Rosado - Bruno Laganà - Raffaele D’Amelio

Source: https://link.springer.com/

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