Clinical and experimental rheumatology最新文献

{"title":"Clinical and serological features of systemic sclerosis patients, according to different geographic areas: insights from an observational, cross-sectional study of two independent cohorts.","authors":"Vasiliki Liakouli, Hesham Hamoud, Mahmoud Ibrahim Risha, Mohamed Elsayed Hanafy, Abdelhafeez Moshrif, Rasha A Abdel-Magied, Gihan M Omar, Adel M Elsayed, Abdelazeim Elhefny, Sameh Mobasher, Mervat Abo Gabal, Manal Hassanien, Fatma H El Nouby, Khaled Abdelgalil, Giulio Forte, Luca Navarini, Piero Ruscitti, Francesco Ciccia, Roberto Giacomelli","doi":"10.55563/clinexprheumatol/9bhd5d","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/9bhd5d","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the clinical, and serological features and treatments in two independent cohorts of Italian and Egyptian systemic sclerosis (SSc) patients, according to geographic areas.</p><p><strong>Methods: </strong>3 Italian and 5 Egyptian centres participated in patient recruitment in 2017. The demographic, clinical, and serological data were collected and defined according to the previously developed severity score and activity index. The database included 261 consecutive Italian patients (242 women/19 men) and 197 Egyptian patients (177 women/20 men), all of whom fulfilled the classification criteria of ACR/EULAR 2013 and criteria proposed by LeRoy and Medsger.</p><p><strong>Results: </strong>Egyptians were younger, had an earlier onset of both the first non-Raynaud's and Raynaud's phenomenon and a more severe modified skin score. A greater percentage of Egyptians had the active form of the disease, a pulmonary arterial pressure estimated by echocardiography>35mmHg than Italians and interstitial lung disease. The severity score was higher in Egyptians, the frequency of anti-topoisomerase I (ATA) was higher in Italians, and Egyptians were more likely to be negative for both anticentromere and ATA antibodies than Italians. Egyptians had higher rates of synthetic disease-modifying antirheumatic drugs use than Italians; Italians but not Egyptians were under treatment with vasoactive therapy. Notably, Egyptians affected by the limited form of the disease exhibited a more severe clinical course when matched with their Italian counterparts, characterised by higher modified Rodnan skin score (mRSS), more frequent pulmonary involvement, increased frequency of ischaemic digital ulcers, earlier onset of symptoms, and higher severity scores.</p><p><strong>Conclusions: </strong>Clinical differences may be shown between Italian and Egyptian SSc patients.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Composite Autonomic Symptom Score 31 (COMPASS-31) for the assessment of symptoms of autonomic dysfunction in fibromyalgia.","authors":"Fausto Salaffi, Sonia Farah, Maria Giovanna Lommano, Benedetta Bianchi, Maria Chiara Mangiafico, Marco Di Carlo","doi":"10.55563/clinexprheumatol/4j3efd","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/4j3efd","url":null,"abstract":"<p><strong>Objectives: </strong>Autonomic dysfunction is a feature of fibromyalgia (FM). The Composite Autonomic Symptom Score-31 (COMPASS-31) is a validated tool to assess autonomic dysfunction. This study aimed to evaluate autonomic dysfunction in FM patients using COMPASS-31 and examine correlations with FM severity measures.</p><p><strong>Methods: </strong>A cross-sectional study included women with FM and matched healthy controls. Participants completed COMPASS-31, the Revised Fibromyalgia Impact Questionnaire (FIQR), Polysymptomatic Distress Scale (PDS), Modified Fibromyalgia Assessment Status (FASmod), and PainDetect Questionnaire (PDQ). Correlations and severity analyses were performed.</p><p><strong>Results: </strong>The study included 77 women with FM and 77 matched controls. Autonomic dysfunction was observed in 64.9% of FM patients and 3.5% of healthy controls. FM patients exhibited significantly higher COMPASS-31 scores (mean 47.03±17.27) compared to controls (21.55±11.48; p<0.00001). Internal consistency was good (Cronbach's α=0.74). A COMPASS-31 cut-off point of 38.28 (sensitivity 71.43%; specificity 91.86%; LR+ 8.78) distinguished FM patients from healthy controls. COMPASS-31 scores correlated positively with FIQR (rho=0.47, p<0.0001), PDS (rho=0.36, p<0.0001), FASmod (rho=0.32, p=0.004) and PDQ scores (rho=0.56, p<0.0001). Disease severity categories identified by FIQR were significantly associated with autonomic dysfunction symptoms (Kruskal-Wallis test: 18.77; p=0.00086).</p><p><strong>Conclusions: </strong>This study highlights the high prevalence of autonomic dysfunction in FM and supports the utility of COMPASS-31 as a reliable tool for assessing autonomic symptoms in FM patients. Future research should explore the causality and the impact of FM severity on autonomic dysfunction through longitudinal studies.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infections preceding diagnosis associated with myositis phenotypes in a national patient registry.","authors":"Takuma Ohnishi, Jesse Wilkerson, Nastaran Bayat, Payam N Farhadi, Abdullah Faiq, Charles F Dillon, Adam Schiffenbauer, Christine G Parks, Hermine I Brunner, Bob Goldberg, Frederick W Miller, Lisa G Rider","doi":"10.55563/clinexprheumatol/tjpsdy","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/tjpsdy","url":null,"abstract":"<p><strong>Objectives: </strong>We investigated the association of antecedent infections with clinical subgroups and phenotypes in the idiopathic inflammatory myopathies (IIMs).</p><p><strong>Methods: </strong>Adult IIM patients (362 with dermatomyositis (DM), 250 with polymyositis (PM), and 256 with inclusion body myositis (IBM)) enrolled in a national myositis patient registry. One hundred thirty-four patients had symptoms of lung disease plus fever and/or arthritis (LD+), and 103 with systemic autoimmune rheumatic disease-associated overlap myositis (OM). Self-reported infections and antibiotic usage within 12 months prior to IIM diagnosis were examined. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated across IIMs. LD+ and OM analyses were performed excluding IBM patients.</p><p><strong>Results: </strong>Infections before IIM diagnosis were more frequent in DM and PM than IBM. Febrile illness and gastroenteritis were more frequent in DM than IBM (OR 2.82 and 3.30, respectively), and in PM than IBM (OR 3.27 and 3.26, respectively). Patients with LD+ and OM had higher odds of reported infections than those without these phenotypes, with pneumonia the most strongly associated infection (OR 5.26 95% CI 2.59-10.71 in LD+, OR 2.75, 95% CI 1.25-6.06 in OM). Antibiotic usage within 1 year before diagnosis did not differ among DM, PM and IBM patients, nor in OM. Antibiotics were used more frequently used in patients with LD+ compared to no LD, but this was attenuated after adjusting for infections.</p><p><strong>Conclusions: </strong>Antecedent infections, particularly respiratory and gastrointestinal infections may contribute to adult IIM phenotypes. Pneumonia showed the strongest association with myositis phenotypes accompanied by frequent lung disease.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unravelling the relationship between anxiety, autonomic nervous system dysfunction and fibromyalgia: a systematic review.","authors":"Aurora Di Bari, Giulia Demo, Elisabetta Patron","doi":"10.55563/clinexprheumatol/z1jcry","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/z1jcry","url":null,"abstract":"<p><p>Fibromyalgia (FM) is a chronic condition characterised by widespread musculoskeletal pain accompanied by various somatic and psychological debilitating symptoms. Dysfunction of the autonomic nervous system (ANS), as measured by heart rate variability (HRV), including reduced HRV at rest and dysfunctional HRV response patterns, has been consistently reported in patients with FM. Additionally, FM patients commonly exhibit elevated anxiety symptoms and comorbid anxiety disorders. This systematic review aimed to explore the potential relationship between elevated anxiety symptoms and reduced HRV in patients with FM.Through a comprehensive analysis of the literature, the association between anxiety symptoms and HRV was investigated in FM patients under resting conditions and in response to various interventions. The results suggest that the association between reduced HRV and elevated anxiety symptoms in FM patients at rest is widely supported by most studies. Interventions focused on improving HRV, such as exercise, psychotherapy, and mind-body therapies, also appear to be effective in reducing symptoms of anxiety.These findings suggest the presence of a possible common underlying mechanism contributing to the high comorbidity of ANS dysregulation and elevated anxiety symptoms in FM. The observed interconnection between anxiety and HRV highlights the need to develop targeted, multimodal interventions aimed at simultaneously reducing anxiety and improving HRV to enhance the overall quality of life for individuals affected by this complex condition.Collectively, this systematic review underscores the importance of recognising and addressing the intricate interplay between psychological and physiological factors in the management of FM.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical cannabis for chronic pain management: questions and answers between clinical and medico-legal issues.","authors":"Vittorio Schweiger, Barbara Ganz, Alvise Martini, Piercarlo Sarzi-Puttini, Laura Bazzichi, Eleonora Bonora, Patrizia Vendramin, Marta Nizzero, Lorenzo Zamboni, Luca Polati, Fabio Lugoboni, Dario Raniero, Enrico Polati, Giovanna Del Balzo","doi":"10.55563/clinexprheumatol/o23y55","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/o23y55","url":null,"abstract":"<p><p>Medical cannabis (MC) has gained prominence in recent years as a potential therapeutic option for various diseases, with a particular focus on chronic pain syndromes. While its efficacy remains uncertain, the global prescription rates of MC are significantly increasing. Therefore, pain therapists must be well-informed about several aspects of MC treatments, including efficacy, safety, indications, contraindications, pharmacological interactions, dosages, possible adverse events (AEs), such as the risk of addiction, and medico-legal considerations. Based on the available literature, the efficacy of MC on pain of different origins was described by the majority of Authors as statistically significant compared to placebo, with a mean reduction in NRS scale (0-10) from baseline between -0.43 and -0.70. The incidence of serious AEs was rare; however, MC may significantly increase AEs such as dizziness, tiredness, drowsiness and nausea. Common AEs included dry mouth, diarrhoea, constipation and euphoria. Absolute contraindications to MC include unstable cardiovascular diseases, psychotic symptoms, bipolar disorder, both ongoing and/or planned pregnancy and breastfeeding. Regarding addiction, the risk of cannabis use disorder (CUD) according DSM-V is about 29%. From a medico-legal perspective, the Italian legislation considers the MC a symptomatic support to standard treatments and accurately regulates its prescription on part of physicians. Moreover, the pain therapist must inform the patient about the legal implications of MC on driving (in relation to disability and license eligibility), work impairment, insurances, and the possession of firearms, in order to prevent possible negative repercussions on patients, on other subjects and on the pain therapists themselves.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone mineral density is associated with pre-treatment pain levels of complex regional pain syndrome type 1 and predicts the response to N-containing bisphosphonates.","authors":"Vania Braga, Pietro Maistri, Davide Gatti, Carmela Dartizio, Anna Piccinelli, Camilla Benini, Angelo Fassio, Francesco Pollastri, Maurizio Rossini, Ombretta Viapiana, Giovanni Adami","doi":"10.55563/clinexprheumatol/d4fdnb","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/d4fdnb","url":null,"abstract":"<p><strong>Objectives: </strong>Complex regional pain syndrome type 1 (CRPS type 1) is a debilitating pain disorder that often follows trauma or surgery. While bone involvement has been implicated in its pathogenesis, the relationship between systemic bone loss and disease severity or treatment response remains unclear. The aim of this study is to investigate the association between systemic bone loss and CRPS severity and response to treatment.</p><p><strong>Methods: </strong>This prospective observational study enrolled patients with CRPS type 1 diagnosed per IASP criteria. Inclusion criteria were recent post-trauma CRPS (<4 weeks) and treatment initiation within 2 months. Patients received IV neridronate (100 mg/day for 4 days, total 400 mg). Pain was assessed using the Visual Analog Scale (VAS) at baseline and 30 days post-treatment. Dual-energy X-ray absorptiometry (DXA) was used to measure one mineral density (BMD) at the lumbar spine, femoral neck and total hip. Stepwise linear regression and mixed-effects models assessed predictors of baseline pain and treatment response.</p><p><strong>Results: </strong>Sixty-fine CRPS type 1 patients were included in the study. Baseline VAS pain was 70.9±2.19, significantly decreasing to 24±3.8 post-treatment (p<0.001). Lower lumbar spine Z-score correlated with higher baseline pain and predicted greater pain reduction following neridronate (β=-8.7, SE 3.2, p=0.008) independently from age, sex, BMI and limb affected.</p><p><strong>Conclusions: </strong>Lower BMD was associated with greater CRPS severity and better response to treatment. These findings support the roleof bone in CRPS pathogenesis and suggest that DXA-derived Z-scores may help identify patients most likely to benefit from bisphosphonates.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmakon or the healing art: experience of artistic-transformative transdisciplinary workshops in fibromyalgia syndrome.","authors":"Claudia Villani, Monica Sapio, Giuseppina Cassarà, Yoga Patti, Leonora Cupane, Valeria Giorgi, Sonia Farah, Piercarlo Sarzi-Puttini","doi":"10.55563/clinexprheumatol/yxhmcr","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/yxhmcr","url":null,"abstract":"<p><strong>Objectives: </strong>Fibromyalgia syndrome (FM) is a chronic pain syndrome often related to trauma and stress. A multidisciplinary therapeutic approach is recommended. Transformative experiences (TE) allow for a profound and immediate change that helps breaking the maladaptive emotional/behavioural loop elicited by chronic stress and trauma. In this study, TE was specifically elicited through transformative art (TA) in different ways. Aim of this study is the validation of the efficacy (in terms of quality of life and sleep, self-esteem, self-efficacy) of transdisciplinary artistic-transformative pathways in patients with FM.</p><p><strong>Methods: </strong>8-month observational study evaluated the effectiveness of three TA online workshops in FM patients: in group 1 participants reviewed their autobiography and illness in a humorous sense; in group 2 participants were guided to express their realities of illness in poetry; group 3 was based on the guided narration of works of art according to visual thinking strategies integrated with the principles of narrative medicine. Tests were administered at baseline and post-workshop.</p><p><strong>Results: </strong>109 FM patients completed the study. No differences were found among the three groups at baseline in terms of clinimetric variables. Overall, the three groups showed a statistically significant improvement of the Pittsburgh Sleep Quality Index (PSQI), Response to Stressful Experiences Scale (RSES), WHO-5 Well-Being Index (WHO-5) and Global Health scale (GH). No significant difference was found for The Mindful Attention Awareness Scale. In Group 1, patients ameliorated in almost all parameters. Sleep and the 3rd dimension of SAP improved in patients of Group 2, whilst self-esteem and WHO-5 did in Group 3.</p><p><strong>Conclusions: </strong>Our research shows that art as TA leads to significant improvements of the psychophysical condition of FMS patients. TA can be seen as a crucial mediator for overcoming the trauma/stressors, likely by generating \"pivotal mental states\" that aid rapid, deep learning, mediating psychological transformation to overcome trauma and stress.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of medical cannabis on gastrointestinal symptoms in fibromyalgia and disorders of gut-brain interaction: a patient‑centred real‑world observational study.","authors":"Antonella Santonicola, Paolo Moscato, Carlo Soldaini, Gabriella Loi, Anna Merchionda, Paola D'Addieco, Anna Lauritano, Greta Pellegrino, Piercarlo Sarzi Puttini, Paola Iovino","doi":"10.55563/clinexprheumatol/o5ck22","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/o5ck22","url":null,"abstract":"<p><strong>Objectives: </strong>Fibromyalgia (FM) is frequently associated with gastrointestinal (GI) disorders such as disorders of gut-brain interaction (DGBIs). Current treatments for FM offer limited relief, leading to the exploration of alternative therapies such as medical cannabis. This study evaluates in the impact of Bedrocan® medical cannabis in FM patients and GI symptoms over six months.</p><p><strong>Methods: </strong>Sixty FM patients were enrolled, receiving a Bedrocan® cannabis treatment for 6 months. A standardised questionnaire evaluating upper and lower GI symptoms and the Revised Fibromyalgia Impact Questionnaire (FIQR) evaluating FM severity were administered at enrolment and 3 and 6-month follow-up evaluations. DGBIs, in particular, irritable bowel syndrome (IBS), and functional dyspepsia (FD) were diagnosed according to Rome IV criteria.</p><p><strong>Results: </strong>Forty-six/60 (76.6%) FM patients fulfilled the diagnostic criteria for at least one DGBI; 10/60 (16.7%) FM patients fulfilled the diagnostic criteria for IBS, 17/60 (28.3%) for FD, and 19/60 (31.7%) for both IBS/FD. The FIQR severity score log-transformed significantly decreased during the months-by-month comparison period (repeated-measures ANOVA, p<0.001). Among GI symptoms, the log-transformed intensity-frequency score of epigastric pain, epigastric burning, abdominal pain, abdominal distension, and bloating significantly decreased during the month-by-month comparison period (repeated-measures ANOVA, p<0.01).</p><p><strong>Conclusions: </strong>This study supports Bedrocan® medical cannabis as an alternative treatment for FM with a potential effect on FD and IBS symptoms. Despite positive outcomes, the study acknowledges limitations, such as the small sample size and absence of a control group. Further research is required to confirm the efficacy of medical cannabis in FM patients, particularly regarding its effects on GI symptoms.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is it time to review the 2016 American College of Rheumatology diagnostic criteria for fibromyalgia?","authors":"Gianniantonio Cassisi","doi":"10.55563/clinexprheumatol/hpuhzb","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/hpuhzb","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The microbiota in axial spondyloarthritis: what have we learned from Mendelian randomisation studies?","authors":"Matthew L Stoll, Mary Appah, Hemant K Tiwari","doi":"10.55563/clinexprheumatol/rvb37m","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/rvb37m","url":null,"abstract":"<p><strong>Objectives: </strong>It has been postulated that the gut microbiota plays an important role in the pathogenesis of spondyloarthritis (SpA). However, cross-sectional studies are limited in their ability to differentiate disease-driven microbial alterations from causative changes. Mendelian randomisation (MR) studies leverage existing genetic associations to investigate causality, offering insights into microbiota-disease associations.</p><p><strong>Methods: </strong>We conducted a systematic review of all MR studies that evaluated the relationship between the microbiota and axial SpA. Eight studies were identified and reviewed. To look for genetic associations with the microbiota, all of them used the MiBioGen microbiota genome-wide association study (GWAS), with one also using the Dutch Microbiome Project. To find associations between the human genome and disease, various data sources were used, including the published GWAS in ankylosing spondylitis (AS), FinnGen, the UK Biobank, and the Integrative Epidemiology Unit (IEU) Open GWAS project.</p><p><strong>Results: </strong>MR findings revealed predicted increased abundances of Ruminococcaceae NK4A214 and Verrucomicrobia among others, alongside decreased abundances of Lactobacillaceae, and Rikenellaceae families, as well as the Bacteroides genus. These findings largely support the results from cross-sectional studies of the microbiota in patients with SpA. They suggest that bacteria that disrupt gut barrier function may result in an increased risk of SpA, while the opposite may be true with bacteria such as Alistipes and Bacteroides that may have a protective role.</p><p><strong>Conclusions: </strong>These results underscore the interplay of genetics, microbiota, and disease. Further research is needed to refine these findings and optimise therapeutic approaches.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}