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Spondyloarthritis (SpA) is a group of inflammatory diseases with overlapping clinical features, which also share a genetic background. Bacterial infections of the gastrointestinal or genitourinary tract are the most important environmental factors associated with SpA development. Recent data show that intracellular bacteria may spread the infection to other anatomical locations. In patients suffering from SpA, extra-articular manifestations, especially intestinal inflammation, are common. Recent progress in understanding the role of intestinal microbiota in gut homeostasis and accumulating data showing the implication of microbiome disruption in the development of various diseases also shed more light on SpA pathogenesis. It is proposed that SpA may originate from the relocation to the joints of the immune response induced primarily in the gut. The intestinal dysbiosis caused by genetic and environmental factors is the most likely cause of SpA-associated gut inflammation

New aspects of spondyloarthritis pathogenesis. Part II – environmental factors, microbiome disturbances, extra-articular symptoms