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Ann Rheum Dis. 2017 Sep;76(9):1614-1622. doi: 10.1136/annrheumdis-2016-211064. Epub 2017 Jun 12.

Faecal microbiota study reveals specific dysbiosis in spondyloarthritis.

Author information

Université de Versailles-Saint-Quentin, Montigny-le-Bretonneux, France.
Université Paris Descartes, Sorbonne Paris Cité, Laboratoire d'Excellence Inflamex, Paris, France.
Service de Rhumatologie, Hôpital Ambroise Paré, Assistance Publique-Hôpitaux de Paris, Boulogne, France.
Micalis Institute, INRA, AgroParisTech, Université ParisSaclay, Jouy-en-Josas, France.
MetaGenoPolis, INRA, Université Paris-Saclay, Jouy-en-Josas, France.
Department of Gastroenterology, Saint Antoine Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.
Sorbonne University-UPMC Univ Paris 06, INSERM ERL 1157, Avenir Team Gut Microbiota and Immunity, Paris, France.
Service d'Immunologie, Hôpital Ambroise Paré, Assistance Publique - Hôpitaux de Paris, Boulogne, France.



Altered microbiota composition or dysbiosis is suspected to be implicated in the pathogenesis of chronic inflammatory diseases, such as spondyloarthritis (SpA) and rheumatoid arthritis (RA).


16S ribosomal RNA gene sequencing was performed on faecal DNA isolated from stool samples in two consecutive cross-sectional cohorts, each comprising three groups of adult volunteers: SpA, RA and healthy controls (HCs). In the second study, HCs comprised a majority of aged-matched siblings of patients with known HLA-B27 status. Alpha and beta diversities were assessed using QIIME, and comparisons were performed using linear discriminant analysis effect size to examine differences between groups.


In both cohorts, dysbiosis was evidenced in SpA and RA, as compared with HCs, and was disease specific. A restriction of microbiota biodiversity was detected in both disease groups. The most striking change was a twofold to threefold increased abundance of Ruminococcus gnavus in SpA, as compared with both RA and HCs that was significant in both studies and positively correlated with disease activity in patients having a history of inflammatory bowel disease (IBD). Among HCs, significant difference in microbiota composition were also detected between HLA-B27+ and HLA-B27 negative siblings, suggesting that genetic background may influence gut microbiota composition.


Our results suggest that distinctive dysbiosis characterise both SpA and RA and evidence a reproducible increase in R. gnavus that appears specific for SpA and a marker of disease activity. This observation is consistent with the known proinflammatory role of this bacteria and its association with IBD. It may provide an explanation for the link that exists between SpA and IBD.


ankylosing spondylitis; infection; inflammation; rheumatoid arthritis; spondyloarthritis

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