scholarly journals AB0669 PARTICULARITIES OF TUNISIAN FEMALE AXIAL SPONDYLOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1629.2-1629
Author(s):  
K. Ben Abdelghani ◽  
Y. Gzam ◽  
A. Fazaa ◽  
S. Miladi ◽  
K. Ouenniche ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Axial Spondyloarthritis ◽  
Activity Index ◽  
Age At Onset ◽  
Disease Onset ◽  
Disease Activity Index ◽  
Reactive Protein ◽  
Significant Difference ◽  
The Mean

Background:Axial spondyloarthritis (ax-SpA) is a chronic rheumatic disease that mainly affects men. However, the female form of ax-SpA remains insufficiently studied.Objectives:The aim of this study was to determine the clinical characteristics, the disease activity and the functional impact of female ax-SpA in comparison with male ax-SpA.Methods:This is a retrospective study including patients diagnosed with ax-SpA fulfilling the criteria of the Assessment of SpondyloArthritis international Society (ASAS) 2009.Clinical parameters, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Bath ankylosing spondylitis disease activity index (BASDAI) and Bath ankylosing spondylitis functional index (BASFI) were compared between groups of female and male ax-SpA.Results:Two hundred ax-SpA patients were included with 31% of female (n=62) and a mean age of 43,3 ± 11,2 years.The mean age at onset of symptoms was 31,8 ± 8,9 years for women and 25,3 ± 9,1 years for men (p <0,0001). The mean age at diagnosis was 36,4 ± 9,6 years for women and 31,7 ± 10,4 years for men (p = 0,003). Ax-SpA with juvenile onset was noted in 1,7% of women and 12,1% of men (p = 0,02). Male ax-SpA were significantly more smokers (46.8% vs 5.4%; p <0.001). The mean duration of morning stiffness was 11,3 ± 9,2 minutes for women versus 21,6 ± 19,3 minutes for men (p = 0,005).The mean ESR was 42,4 ± 29,8 mm for women and 28,3 ± 23,4 mm for men (p = 0,001). Radiographic sacroiliitis was present in 69,3% of women versus 84,7% of men (p = 0,01). The use of anti-TNF alpha was less frequent in women (29% vs 48,5%; p = 0,01).Our study didn’t found a statistically significant difference in peripheral manifestations, extraarticular manifestations, CRP, BASDAI and BASFI between the two groups.Conclusion:Female ax-SpA seems to have a better prognosis than male with older age in disease onset, less inflammation, less radiographic sacroiliitis and less use of biological treatments.References:[1]Rusman T, et al. Curr Rheumatol Rep. 2018; 20(6).[2]Siar N, et al. Curr Rheumatol Rev. 2019;Disclosure of Interests:None declared

scholarly journals Serum Oxytocin Levels in Patients with Ankylosing Spondylitis and Non-Radiographic Axial Spondyloarthritis and their Association with Disease Activity

2021 ◽  
Author(s):  
Ozkan Yukselmis ◽  
Pelin Oktayoğlu ◽  
Mehmet Caglayan ◽  
Nuriye Mete
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Axial Spondyloarthritis ◽  
Complete Blood Count ◽  
Inflammatory Diseases ◽  
Activity Index ◽  
Disease Activity Index ◽  
Serum Levels ◽  
Spinal Mobility ◽  
Significant Difference

Abstract Objectives Spondyloarthritis refers to a group of chronic inflammatory diseases that particularly involve the sacroiliac joints and spine but may also have an influence on extra-articular involvement in some patients. Oxytocin is a peptide hormone released from the hypothalamus and stored in the pituitary gland. It is known to have anti-inflammatory effects. The aim of this study was to investigate the serum levels of oxytocin and their potential association with disease activity and spinal mobility in patients with ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nrAxSpA). Material and Methods Seventy-one patients with nrAxSpA, 38 patients with AS and 67 healthy control subjects were included in this study. Disease activity was assessed by the Bath Ankylosing Spondylitis Disease Activity Index, and spinal mobility by the Bath Ankylosing Spondylitis Metrologic Index. Laboratory examinations included complete blood count, ESR, CRP and oxytocin tests. Results There was no significant difference in serum levels of oxytocin among the 3 groups (p=0.973). However, serum levels of oxytocin correlated negatively with both ESR (r=− 0.359, p=0.027), CRP (r=− 0.316, p=0.056) and BASDAI scores (r=− 0,448, p=0.005) in patients with AS. On the other hand, serum levels of oxytocin had a negative correlation only with ESR in patients with nrAxSpA (r=− 0.321 p=0.009).Conclusion This study lays the foundation for further studies that may aim to investigate how addition of oxytocin to the treatment regimen impacts on disease activity in patients with AS who exhibit particularly low levels of oxytocin during the active disease period.

scholarly journals AB0840 DIAGNOSIS VALUE OF INTERLEUKIN 23 IN SPONDYLOARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1443.3-1444
Author(s):  
L. Kharrat ◽  
M. Slouma ◽  
A. Tezeghdenti ◽  
W. Dkhili ◽  
R. Dhahri ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Activity Index ◽  
Disease Activity Index ◽  
Enzyme Linked Immunosorbent Assay ◽  
Healthy Controls ◽  
Reactive Protein ◽  
Asas Criteria ◽  
The Mean ◽  
Interleukin 23

Background:Interleukin 23 (IL-23) is a pivotal pro-inflammatory cytokine in the Th17/IL-23 axis which became the center of attention in researches during these last decades, especially during spondyloarthritis (1).Objectives:We aimed to study the diagnosis value of IL-23 serum in spondyloarthritis.Methods:We conducted a case-control study, including 144 subjects divided into 2 groups:-G1: 72 patients meeting the Assessment of SpondyloArthritis International Society (ASAS) criteria for spondyloarthritis (SA)-G2: 72 healthy controls matched for age and sex.For each SA patient we collected the following parameters: BASDAI (Bath Ankylosing Spondylitis Disease Activity Index), ASDAS (Ankylosing Spondylitis Disease Activity Score), BASFI (Bath Ankylosing Spondylitis Functional Index), and BASRI (Bath Ankylosing Spondylitis Radiology Index).The IL-23 level was measured using Enzyme-linked immunosorbent assay (ELISA).Erythrocyte Sedimentation rate (ESR) and C-reactive protein (CRP) were also measured.We performed a ROC analysis and computed the air under the curve (AUC) at IL-23 to diagnose SA patients.Statistical analysis was performed using “IBM SPSS Statistics” software version 25.Results:The study included 57 men and 15 women. The mean age was 44.84 ± 13.42 years. The mean age at the onset of the disease was 35.97 ± 12.88 years. The disease duration was 8.54 ± 7.7 years.Seventy-nine per cent of our patients had axial radiographic spondyloarthritis (n=57). Peripheral involvement was found in 45.8% (n=33). Eighteen patients had both axial and peripheral involvement concomitantly. Psoriasis was found in 36.1% of the cases (n=26).The mean BASDAI and ASDAS-CRP were 3.21 ± 1.64 and 3.05 ± 1.51, respectively.The mean was BASFI 3.88 ± 2.69. The mean was BASRI 5.26 ± 4.14.The mean ESR and CRP were 36.74 ± 29.38 mm/hr and 20.45 ± 25.19 mg/dL, respectively.IL-23 level was significantly higher in patients compared to healthy controls (23.1 ± 2.72 pg/mL and 5.02 ± 0.59 pg/mL, respectively, p<0.0001).As shown in Figure 1, the AUC value to distinguish between spondyloarthritis and healthy control was 0.705 (p<0.0001). IL-23 cut-off was 7.96 pg/mL (Sensibility= 69.4%, specificity=98.6%).Figure 1.AUC at IL-23 between SA patients 0.705 (p<0.0001) Nevertheless, no correlation was found between serum IL-23 levels and the following parameters: ESR, CRP, BASDAI, ASDAS-CRP, BASFI and BASRI.Conclusion:As reported to previous studies, our study showed that IL-23 is significantly higher in SA patients (2).Interestingly, IL-23 was able to distinguish between SA patients and healthy controls with a cut-off of 7.96 pg/mL. This finding suggests that IL-23 may be practical for the diagnosis of SA.References:[1]K V, D E. IL-23 Responsive Innate-Like T Cells in Spondyloarthritis: The Less Frequent They Are, the More Vital They Appear [Internet]. Vol. 17, Current rheumatology reports. Curr Rheumatol Rep; 2015 [cité 13 avr 2020]. Disponible sur: https://pubmed.ncbi.nlm.nih.gov/25874346/[2]Wang X, Lin Z, Wei Q, Jiang Y, Gu J. Expression of IL-23 and IL-17 and effect of IL-23 on IL-17 production in ankylosing spondylitis. Rheumatol Int. sept 2009;29(11):1343-7.Disclosure of Interests:None declared

scholarly journals The effects of alcohol consumption and its associations with disease activity among 979 patients with inflammatory arthritis

RMD Open ◽  
2021 ◽  
Vol 7 (2) ◽  
pp. e001510
Author(s):  
Matthew Turk ◽  
Kieran Murray ◽  
Yousef Alammari ◽  
Aine Gorman ◽  
Francis Young ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Alcohol Consumption ◽  
Disease Activity ◽  
Inflammatory Arthritis ◽  
Activity Index ◽  
Severe Disease ◽  
Disease Activity Index ◽  
Reactive Protein ◽  
Significant Difference

ObjectiveThe role of alcohol in inflammatory disease remains debated. This study explores the relationship between alcohol and disease activity in patients with inflammatory arthritis.MethodsPatients attending a rheumatology clinic between 2010 and 2020 were prospectively followed. Information on demographics, alcohol use, smoking habits and disease outcome measures were collected from these patients. Statistical analysis included univariate and multivariate linear and binary logistic regressions, Mann-Whitney U tests and one-way analysis of variance with Tukey’s honest significant difference (HSD) test.ResultsOf the 979 analysed patients, 62% had rheumatoid arthritis (RA), 26.7% had psoriatic arthritis (PsA) and 11.2% had ankylosing spondylitis. Mean DAS28-CRP (Disease Activity Score 28 - C-reactive protein) in RA and PsA at 1 year was 2.96±1.39, and 64.2% of patients were in remission (DAS28-CRP ≤2.6 or BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) ≤4). Both male gender and risky drinking (>15 units of weekly alcohol) were significantly associated with remission. Compared with women, men had an OR of 1.8 (1.1, 2.5) (p=0.034) for any alcohol consumption and 6.9 (4.7, 9.1) (p=0.001) for drinking at least 15 weekly drinks. When adjusted for gender, there was no association between alcohol and disease activity. Yet, when adjusted for alcohol consumption, gender still significantly influenced disease activity.ConclusionWhile it may appear that alcohol is linked to remission in inflammatory arthritis, when adjusted for gender, it is not. Men with inflammatory arthritis drink significantly more than women and have less severe disease activity.

scholarly journals AB0664 DIAGNOSIS DELAY IN ANKYLOSING SPONDYLITIS PATIENTS IN EGYPT: FACTORS, SOCIOECONOMIC AND CLINICAL OUTCOME

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1627.2-1627
Author(s):  
F. I. Abdelrahman ◽  
M. Mortada
Keyword(s):  
Ankylosing Spondylitis ◽  
Social Life ◽  
Activity Index ◽  
Diagnostic Delay ◽  
Disease Activity Index ◽  
Diagnosis Delay ◽  
Functional Index ◽  
Delay In Diagnosis ◽  
Significant Difference ◽  
The Mean

Background:Ankylosing spondylitis (AS) is a destructive inflammatory disease which was reported to have the longest diagnostic delay among the inflammatory rheumatic disease. This lag period have a great impact on the clinical outcome and socioeconomic state of the patients. With the advent of tumor necrosis factor-α (TNF-α) inhibitors, early diagnosis in AS has become important(1).Objectives:to evaluate the period from symptom onset to diagnosis of AS in Egyptian patients and to examine possible reasons for delayed diagnosis and its impact on the economic and social life of the patients.Methods:The study included 87 AS patients diagnosed according to the Assessment of Spondyloarthritis international Society (ASAS) criteria (2). A face-to-face interview was applied to take medical history, and a questionnaire that contains some clinical aspects of disease was used. Diagnosis delay was described as the gap between first AS symptom and correct diagnosis of AS. Clinical and functional assessment of axial SpA measured by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI). The direct medical cost during years of delay (including costs of medical consultations, medications, investigations, physiotherapy and surgical treatment) had been estimated by Egyptian pound.Results:The study included 87 AS patients with mean age (30.03±8.3), 70 male (80.5%) and 17 female (19.5%).Mean delay in diagnosis was(5.7 ±4.9) years. Mean of diagnostic delay for patient diagnosed before 2010 is (14±4.4) and that of patients diagnosed after 2010 is (3.5±1.8) with significant difference between both (p value<0.0001). The main cause of delay was incorrect diagnosis as follow degenerative disc disease (43/87, 49.4%), non-specific back pain (31/87, 35.6%), rheumatoid arthritis (10/87,11.5%), rheumatic fever (2/87, 2.3%) and tuberculosis of spine (1/87, 1.1%). The mean of the medical visits was (6±5.4). Most incorrect initial diagnoses were made by orthopedicians (57.9%), followed by neurologists (22.2%) followed by rheumatologist (10%) and general phyisicians (9.9%). Absence of extra-articular manifestations, negative family history and juvenile age are significantly associated with diagnostic delay. Delay in diagnosis is significantly associated with higher disease activity index(BASDAI), functional index (BASFI), and damage index(BASMI). The mean of the costs during years of delay is (15671.3±546.1) with the mean of cost per each year delay (660.9±6.6) with high significant association between the cost and longer delay in diagnosis (<0.0001). Regarding work ability, we found that(32.2%) are fit for work, unfit (29.9%), partially fit (37.9%) with high significant difference between ability of work and shorter delay. Regarding social effect, 40.2 % of patients developed negative effect on social life with significant association to diagnostic delay (0.004).Conclusion:Our study confirmed the importance of early diagnosis of AS due to its impact on patient’s health outcome and socioeconomic state.We recommend to increase the awareness about the disease among healthcare professionals in our region.References:[1]Sykes M. et al: Diagnostic delay in patients with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis; Ann Rheum Dis.2015;74:e44.[2]Rudwaleit M. et al: The development of Assessment of Spondyloarthritis international Society classification criteria for axial spondyloarthritis; Ann Rheum Dis, 68 (2009), pp.777-783.Disclosure of Interests:None declared

scholarly journals SAT0364 DATA TO BE COLLECTED FOR AN OPTIMAL MANAGEMENT OF AXIAL SPONDYLOARTHRITIS IN DAILY PRACTICE: PROPOSAL FROM AN EVIDENCE BASED AND CONSENSUAL APPROACHES

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1129.1-1129
Author(s):  
A. Baillet ◽  
X. Romand ◽  
A. Pfimlin ◽  
M. Dalecky ◽  
M. Dougados
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Axial Spondyloarthritis ◽  
Activity Index ◽  
Disease Activity Index ◽  
Daily Practice ◽  
Evidence Based ◽  
Periodic Review ◽  
Grade Scale

Background:Standardization of clinical practice has been proven to be effective in management of chronic diseases. This is particularly true at the time where the concept of treat to target is becoming more and more important in the field of axial spondyloarthritis (ax-SpA).Objectives:To propose a list of variables to be collected at the time of the diagnosis and over the follow-up of patients with axial spondyloarthritis (ax-SpA) for an optimal management in daily practice.Methods:The process comprised (1) the evaluation of the interest of 51 variables proposed for the assessment of axSpA via a systematic literature research, (2) a consensus process involving 78 hospital-based or office-based rheumatologists, considering the collection of the variable in a 4 grade scale from ”potentially useful” to “mandatory”, (3) a consensus on optimal timeline for periodic assessment of the selected variables on a 5 grade scale from “at each visit” to “never to be re-collected”.Results:The systematic literature research retrieved a total of 14,133 abstracts, of which 213 were included in the final qualitative synthesis. Concerning the data to be collected at the time of the diagnosis and during follow-up, we proposed to differentiate the results based on a) the way of collection of the variables (e.g. questionnaires by the patient, interview by the physician, physical examination, investigations) b) the usefulness these variables in daily practice based on the opinion of the rheumatologists ” c) the optimal timeline between 2 evaluations of the variable based on the opinion of the rheumatologists. In the initial systematic review, symptoms of heart failure history of inflammatory bowel disease, psoriasis or uveitis, patient global visual analogic scale, spine radiographs, modified Schöber test, coxo-femoral rotations, swollen joint count, urine strip test, BASDAI and ASDAS global scores were considered very useful and nocturnal back pain/morning stiffness, sacro-iliac joints radiographs and CRP were considered mandatory (Figure 1). Timeline between 2 evaluations of variables to collect in the periodic review are summarized inFigure 2.Figure 1.Core sets of items to collect and report in the systematic review in axial spondyloarthritis management in daily practice ASDAS=Ankylosing Spondylitis Disease Activity Score, BASDAI=Bath Ankylosing Spondylitis Disease Activity Index, BASFI=Bath Ankylosing Spondylitis Functionnal Index, BASMI=Bath Ankylosing Spondylitis Metrology Index, CRP=C Reactive Protein, CT=computerized tomography, FIRST=Fibromyalgia Rapid Screening Tool, HLA=Human Leukocyte Antigen, MRI=Magnetic resonance imaging, PET=positron emission tomography.Figure 2.Periodic review timeline of variables to collectASDAS=Ankylosing Spondylitis Disease Activity Score, BASDAI=Bath Ankylosing Spondylitis Disease Activity Index, Spondylitis Metrology Index, CRP=C Reactive Protein, IBD = inflammatory bowel diseases, PRO = Patient Reported OutcomesConclusion:Using an evidence-based and an expert consensus approaches, this initiative defined a core set of variables to be collected and reported at the time of the diagnosis and during follow-up of patients with ax-SpA in daily practice.Acknowledgments:this study has been conducted in two parts: the first one (evidence-based) was conducted thanks to a support from Abbvie France. AbbVie did not review the content or have influence on this manuscript. The second part of this initiative (consensus) has been conducted thanks to a support from the scientific non-profit organization: Association de Recherche Clinique en RhumatologieDisclosure of Interests:Athan Baillet Consultant of: Athan BAILLET has received honorarium fees from Abbvie for his participation as the coordinator of the systematic literature review, Xavier Romand Consultant of: Xavier ROMAND has received honorarium fees from Abbvie, Arnaud Pfimlin Consultant of: Arnaud PFIMLIN has received honorarium fees from Abbvie, Mickael Dalecky Consultant of: Mickael DALECKY has received honorarium fees from Abbvie, Maxime Dougados Grant/research support from: AbbVie, Eli Lilly, Merck, Novartis, Pfizer and UCB Pharma, Consultant of: AbbVie, Eli Lilly, Merck, Novartis, Pfizer and UCB Pharma, Speakers bureau: AbbVie, Eli Lilly, Merck, Novartis, Pfizer and UCB Pharma

Assessment of Preclinical Atherosclerosis in Patients with Ankylosing Spondylitis

2012 ◽  
Vol 39 (2) ◽  
pp. 322-326 ◽  
Author(s):  
WAFA HAMDI ◽  
MOUNA CHELLI BOUAZIZ ◽  
IMEN ZOUCH ◽  
MOHAMED MEHDI GHANNOUCHI ◽  
MANEL HAOUEL ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Structural Damage ◽  
Activity Index ◽  
Age At Onset ◽  
Disease Activity Index ◽  
Mobility Limitations ◽  
Increased Risk ◽  
Preclinical Atherosclerosis

Objective.Epidemiological studies recently confirmed the increased risk of vascular morbidity and mortality during ankylosing spondylitis (AS). Increase of intima-media thickness (IMT) of the common carotid artery is a useful and noninvasive marker of preclinical atherosclerosis. The aim of our study was to compare IMT in patients with AS with matched controls and to determine risk factors of atherosclerosis related to AS.Methods.We performed a prospective study of 60 consecutive patients meeting modified New York criteria for AS, compared to 60 controls matched for age and sex. Disease-specific measures were determined. Measurement of IMT was performed by the same radiologist using the same machine and probe in right and left common carotid arteries, and the average of the 2 measurements was considered.Results.In total 48 male and 12 female patients were recruited, and 60 corresponding controls; mean age was 36 ± 11 years. We found significantly increased IMT in the AS group (0.51 ± 0.12 mm) compared with controls (0.39 ± 0.09 mm; p = 0.001). After adjustment for confounding factors, increased IMT was still present (p = 0.003). Age at onset of AS (p = 0.001), Bath AS Disease Activity Index (p = 0.002), AS Disease Activity Score (ASDAS) erythrocyte sedimentation rate (ESR; p = 0.047), ASDAS C-reactive protein (CRP; p = 0.012), Bath AS Functional Index (p = 0.008), global spine visual analog scale for pain (p = 0.000), Schober index (p = 0.039), Bath AS Metrology Index (p = 0.028), modified Stoke Ankylosing Spondylitis Spine Score (p = 0.035), and high ESR (p = 0.001) and CRP (p = 0.000) were correlated with high IMT in patients with AS. Otherwise, status of arthritis (p = 0.442), enthesitis (p = 0.482), and HLA-B27 (p = 0.528) seemed to have no effect on IMT.Conclusion.AS is associated with an increased risk of atherosclerosis independent of traditional risk factors. Disease activity, functional and mobility limitations, structural damage, and inflammation are the most incriminated risk factors.

scholarly journals Altered Bacterial-Fungal Interkingdom Networks in the Guts of Ankylosing Spondylitis Patients

mSystems ◽  
2019 ◽  
Vol 4 (2) ◽  
Author(s):  
Ming Li ◽  
Bingbing Dai ◽  
Yawei Tang ◽  
Lei Lei ◽  
Ningning Li ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Large Scale ◽  
Activity Index ◽  
Disease Activity Index ◽  
Rrna Gene ◽  
Human Gut ◽  
Reactive Protein ◽  
Inflammatory Drugs ◽  
Bacteria And Fungi

ABSTRACT Intestinal bacterial dysbiosis has been increasingly linked to ankylosing spondylitis (AS), which is a prototypic and best studied subtype of spondyloarthritis (SpA). Fungi and bacteria coexist in the human gut and interact with each other. Although they have been shown to contribute actively to health or disease, no studies have investigated whether the fungal microbiota in AS patients is perturbed. In this study, fecal samples from 22 AS patients, with clinical and radiographic assessments, and 16 healthy controls (HCs) were collected to systematically characterize the gut microbiota and mycobiota in AS patients by 16S rRNA gene- and ITS2-based DNA sequencing. Our results showed that the microbiota of AS patients was characterized by increased abundance of Proteobacteria and decreased Bacteroidetes, which was contributed by enrichment of Escherichia-Shigella, Veillonella, Lachnospiraceae NK4A136 group, and reduction of Prevotella strain 9, Megamona, and Fusobacterium. The gut mycobiota of AS patients was characterized by higher levels of Ascomycota, especially the class of Dothideomycetes, and decreased abundance of Basidiomycota, which was mainly contributed by the decease of Agaricales. Compared to HCs, decreased ITS2/16S biodiversity ratios and altered bacterial-fungal interkingdom networks were observed in AS patients. Compared with nonsteroidal anti-inflammatory drugs (NSAIDs), treating AS patients with biological agents induced obvious changes in the gut mycobiota, and this result was highly associated with disease activity indexes, including AS disease activity index (ASDAS) C-reactive protein (asCRP), erythrocyte sedimentation rate (ESR), and Bath AS disease activity index (BASDAI). In addition, altered mycobiota in AS patients was also found associated with the degree of radiographic damage. IMPORTANCE The human gut is colonized by diverse fungi (mycobiota), and fungi have long been suspected in the pathogenesis of SpA. Our study unraveled a disease-specific interkingdom network alteration in AS, suggesting that fungi, or the interkingdom interactions between bacteria and fungi, may play an essential role in AS development. However, our study is limited by sample size, and in-depth mechanism studies and additional large-scale investigations characterizing the gut mycobiome in AS patients are needed to form a foundation for research into the relationship between mycobiota dysbiosis and AS development.

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