title: Subclinical gut inflammation in ankylosing spondylitis.
abstract: OBJECTIVE
  Subclinical gut inflammation has been described in a significant proportion of patients with ankylosing spondylitis (AS), up to 10% of them developing it during the time of clinically overt inflammatory bowel disease. Histologic, immunologic, and intestinal microbiota alterations characterize the AS gut.
  
  
  RESULTS
  Microbial dysbiosis as well as alterations of innate immune responses have been demonstrated in the gut of AS. Furthermore, a growing body of evidence suggests that the gut of AS patients may be actively involved in the pathogenesis of AS through the production of proinflammatory cytokines, such as IL-23p19, and the differentiation of potentially pathogenic innate lymphoid cells producing IL-22 and IL-17. Finally, a strong correlation between the presence of subclinical gut inflammation and the degree of spine inflammation have been also proved in AS.
  
  
  CONCLUSIONS
  Subclinical gut inflammation and innate immune responses in AS may be considered a possible consequence of microbial dysbiosis. Relationships between cause and effect remain, however, to be answered.
authors.affiliation: aDipartimento Biomedico di Medicina Interna e Specialistica, Sezione di Reumatologia, Università degli Studi di Palermo bDipartimento di Oncoematologia, Azienda Ospedaliera Ospedali riuniti Villa Sofia-Cervello, Palermo, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Ciccia
authors.forename: Aroldo
authors.initials: A
authors.lastname: Rizzo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Triolo
mesh_terms: D056704:Adaptive Immunity; D000818:Animals; D016207:Cytokines / Q000096:biosynthesis; D004195:Disease Models, Animal; D064806:Dysbiosis / Q000276:immunology; D000069196:Gastrointestinal Microbiome / Q000276:immunology; D006801:Humans; D007113:Immunity, Innate; D007249:Inflammation / Q000276:immunology; D015212:Inflammatory Bowel Diseases / Q000276:immunology* / Q000473:pathology; D007422:Intestines / Q000276:immunology / Q000473:pathology; D008264:Macrophages / Q000276:immunology; D051379:Mice; D013167:Spondylitis, Ankylosing / Q000150:complications / Q000276:immunology*
chemical_list: D016207:Cytokines