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Remarkably, these effects can be present simultaneously in the same patient. The search for a potential unifying cause of effects on the skeleton necessarily focuses on inflammation arising from the dysregulation of immune response to microorganisms, particularly dysregulation of T\n                    <jats:sub>H<\/jats:sub>\n                    17 lymphocytes, and the dysbiosis of established gut and other microbiota. The compelling notion that a common antecedent pathological mechanism affects existing bone and tissues with bone-forming potential (entheses), simultaneously with variable effect in the former but bone-forming in the latter, drives basic research forward and focuses our awareness on the effects on these bone mechanisms of the increasing portfolio of targeted immunotherapies used in the clinic.\n                  <\/jats:p>","DOI":"10.1177\/1759720x20969260","type":"journal-article","created":{"date-parts":[[2020,10,30]],"date-time":"2020-10-30T09:22:00Z","timestamp":1604049720000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":36,"title":["Loss and gain of bone in spondyloarthritis: what drives these opposing clinical 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