Characterization of Fecal Microbiota in Ankylosing Spondylitis: Pathogenesis Insights and Therapeutic Opportunities - A Systematic Review

作者：Mahmoud Hashim, Islam Al Ghanam, Warda Hashem, Ahmed Afifi, Mohamed Awad, P. Arias-Sánchez, Herbert Quintanilla, Karun Shrestha, P. Subedi, Lilya Gandrabur · 发表于：Journal of Rheumatology · 年份：2025 · DOI：10.3899/jrheum.2025-0314.79

Recent evidence suggests that the gut microbiota may play a crucial role in the pathogenesis of ankylosing spondylitis (AS). This systematic review aims to examine the existing literature to explore changes in gut microbiota composition between AS patients and healthy controls (HC) to identify microbial signatures associated with AS. Understanding these alterations could enhance our knowledge of the mechanisms underlying AS.We queried PubMed, Web of Science, Scopus, Embase, and Cochrane databases through May 2024 to identify studies comparing stool microbiota composition in AS patients and healthy controls (HC). Following PRISMA guidelines, our search yielded 1,163 studies. We included studies comparing microbiota in AS patients and HC. We excluded duplicates, animal studies, case reports, conference abstracts, non-English articles, irrelevant studies, non-full-text manuscripts, and Mendelian randomization studies, as these do not provide direct observational data on microbiota composition and could introduce methodological heterogeneity.After screening 184 studies, 18 manuscripts were included: 14 prospective cohort studies, 2 case-control studies, and 2 cross-sectional studies (Figure 1). These studies covered a total of 900 ankylosing spondylitis (AS) patients and 734 healthy controls (HC). The majority of the participants were male, with 73.8% in the AS group and 66.7% in the HC group, and most participants (73.4%) were of Asian descent. HLA-B27 status was reported in 13 ...