Modulating the Gut-Joint Axis: The Impact of Anti-TNF Therapy on Gut Microbiota in Ankylosing Spondylitis - A Systematic Review
Bibliographic record
Abstract
Objectives Ankylosing Spondylitis (AS) is a chronic inflammatory disorder that primarily affects the spine and pelvis. Here, we aim to explore the Gut-Joint Axis in AS with a focus on changes in alpha diversity (diversity within a single sample) and beta diversity (differences in microbiota composition between samples) following Anti-TNF treatment. Methods A comprehensive search of PubMed, Web of Science, Scopus, Embase, and Cochrane databases was conducted up to May 2024. Studies comparing fecal microbiota composition in AS patients before and after Anti-TNF therapy were identified and selected based on PRISMA guidelines. From an initial pool of 1,163 studies, 5 met inclusion criteria, involving 230 AS patients and 209 healthy controls (HC). We excluded duplicates, animal studies, case reports, conference abstracts, non-English articles, irrelevant studies, non-full-text manuscripts, and Mendelian randomization studies, as these do not provide direct observational data on microbiota composition and could introduce methodological heterogeneity. Results After manually screening 197 studies, 5 manuscripts were included, comprising 4 prospective cohorts and 1 case-control study. All the studies were conducted in China, with 16S rRNA sequencing used in 3 studies and Shotgun sequencing in 2 studies. None of the patients or controls in the included studies received antibiotics within the 3 months prior to enrollment. Across multiple studies, Anti-TNF therapy significantly impacts gut microbiota composition in AS patients, often shifting it toward a pattern more similar to healthy controls. Both alpha and beta diversity metrics show that AS patients have distinct gut microbiota compositions compared to healthy individuals, but Anti-TNF therapy appears to reduce these differences, suggesting a restorative effect on the microbiome (Table 1). Conclusion Our analysis underscores the potential role of gut microbiota as a target in AS treatment. The effect of Anti-TNF therapy on gut microbiota could potentially contribute to its therapeutic efficacy in managing Ankylosing Spondylitis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.020 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.008 | 0.007 |
| Bibliometrics | 0.008 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".