{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T17:43:32Z","timestamp":1793727812973,"version":"4.6.1"},"reference-count":146,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2020,10,20]],"date-time":"2020-10-20T00:00:00Z","timestamp":1603152000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012632","name":"Nazarbayev University","doi-asserted-by":"publisher","award":["064.01.01 SST 2016022"],"award-info":[{"award-number":["064.01.01 SST 2016022"]}],"id":[{"id":"10.13039\/501100012632","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomolecules"],"abstract":"<jats:p>Spondyloarthritis comprises a group of inflammatory diseases of the joints and spine, with various clinical manifestations. The group includes ankylosing spondylitis, reactive arthritis, psoriatic arthritis, arthritis associated with inflammatory bowel disease, and undifferentiated spondyloarthritis. The exact etiology and pathogenesis of spondyloarthritis are still unknown, but five hypotheses explaining the pathogenesis exist. These hypotheses suggest that spondyloarthritis is caused by arthritogenic peptides, an unfolded protein response, HLA-B*27 homodimer formation, malfunctioning endoplasmic reticulum aminopeptidases, and, last but not least, gut inflammation and dysbiosis. Here we discuss the five hypotheses and the evidence supporting each. In all of these hypotheses, HLA-B*27 plays a central role. It is likely that a combination of these hypotheses, with HLA-B*27 taking center stage, will eventually explain the development of spondyloarthritis in predisposed individuals.<\/jats:p>","DOI":"10.3390\/biom10101461","type":"journal-article","created":{"date-parts":[[2020,10,20]],"date-time":"2020-10-20T20:50:07Z","timestamp":1603227007000},"page":"1461","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":121,"title":["Understanding the Pathogenesis of Spondyloarthritis"],"prefix":"10.3390","volume":"10","author":[{"given":"Aigul","family":"Sharip","sequence":"first","affiliation":[{"name":"Department of Biology, School of Sciences and Humanities, Nazarbayev University, Nur-Sultan 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0776-3233","authenticated-orcid":false,"given":"Jeannette","family":"Kunz","sequence":"additional","affiliation":[{"name":"Department of Biology, School of Sciences and Humanities, Nazarbayev University, Nur-Sultan 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,10,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.1093\/rheumatology\/kei047","article-title":"The current concept of spondyloarthritis with special emphasis on undifferentiated spondyloarthritis","volume":"44","author":"Zochling","year":"2005","journal-title":"Rheumatology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1007\/s11926-013-0362-y","article-title":"Polymorphism of HLA-B27: 105 subtypes currently known","volume":"15","author":"Khan","year":"2013","journal-title":"Curr. 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