Infections and intestinal microbiome in ankylosing spondylitis: clinical, immunopathological, and management implications

Infections et microbiome intestinal dans la spondylarthrite ankylosante: implications cliniques, immunopathologiques et de prise en chargeIntroduction.La spondylarthrite ankylosante (SA) est une arthrite inflammatoire chronique du rachis, fortement associée à l'HLA-B27.Des infections bactériennes et la dysbiose intestinale sont considérées comme des facteurs environnementaux contributifs à sa pathogenèse.L'objectif de l'étude a été d'évaluer la prévalence des infections uro-génitales et entérocolitiques chez les patients atteints de SA, leur impact clinique, et caractériser les altérations du microbiote intestinal par rapport à des témoins sains.Matériel et méthodes.Une étude cas-témoins a inclus 316 patients atteints de SA (âge moyen 41,17±8,82 ans) et 124 témoins sains.L'évaluation clinique reposait sur BASDAI, BASFI, ASDAS, Échelle Visuelle Analogique (EVA) de douleur et paramètres ABSTRACT Introduction.Ankylosing spondylitis (AS) is a chronic inflammatory disease predominantly affecting the axial skeleton, strongly associated with Human Leukocyte Antigen B27 (HLA-B27).Besides genetic predisposition, infectious triggers and intestinal dysbiosis are increasingly recognized as contributors to AS pathogenesis, although their integrated clinical relevance remains incompletely defined.The objective of the study was to evaluate the prevalence of specific urogenital and enterocolitic infections in AS and their association with clinical phenotype and disease activity, and to characterize intestinal microbiota alterations in AS patients compared with healthy controls. Materials and methods.A cross-sectional case-control study included 316 AS patients (236 men, 80 women; mean age 41.17±8.82years) and 124 matched healthy controls.The clinical assessment included Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional