Additional Perspective
Joerg Ermann, MD, a rheumatologist with Brigham and Women’s Hospital, Boston, found the research important because it emphasizes the bi-directional relationship between intestinal microbiota and the human immune system. The study would have been stronger with a larger sample size and better matched experimental groups, he says.
“I think this is an interesting research direction, but results need to be confirmed with a bigger study and subjects randomized to the different treatments. Ideally, one would tag on fecal sample collection to clinical trials,” Dr. Ermann says. He does not think the research into gut microbiota findings is currently of major interest to pharmaceutical companies developing drugs for spondyloarthritis. However, this might change under the influence of studies like the one by Manasson et al.
The field needs a better understanding of who will respond to a specific therapy and who might develop inflammatory bowel disease or other side effects. The analysis of fecal microbiota is a promising approach to the development of much needed biomarkers.
Vanessa Caceres is a medical writer in Bradenton, Fla.
References
- Manasson J, Coras R, Guma M. Interleukin-17 inhibition in spondyloarthritis is associated with subclinical gut microbiome perturbations and a distinctive interleukin-25-driven intestinal inflammation. Arthritis Rheumatol. 2020 Apr;72(4):645–657.
- Busquets D, Mas-de-Xaxars T, Lopez-Siles M, et al. Anti-tumour necrosis factor treatment with adalimumab induces changes in the microbiota of Crohn’s disease. J Crohns Colitis. 2015 Oct;9(10):899–906.