{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T00:09:19Z","timestamp":1793664559679,"version":"4.5.1"},"reference-count":162,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T00:00:00Z","timestamp":1717113600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Spondylarthritis (SpA) is a chronic inflammatory condition that encompasses damage to the axial or peripheral skeleton, accompanied by specific extra-articular symptoms. Within this group, Ankylosing Spondylitis stands out as the hallmark member. Although the heritability of Ankylosing Spondylitis is estimated to be over 95%, only a portion of the heritability has been explained, with HLA-B27 accounting for 20.1% of it; therefore, ongoing research endeavors are currently concentrated on investigating the potential participation of different entities in the development of the disease. Genome-wide association studies have led to significant advances in our understanding of the genetics of SpA. In this descriptive review, we delve into the pathogenesis of Spondylarthritis beyond HLA-B27. We summarize the latest research on the potential participation of various entities in the development of the disease, including other genetic loci, immune dysregulation, microbiota, and environmental factors. The multifactorial nature of SpA and the complex interplay of genetic, immunological, and environmental factors are being increasingly recognized; therefore, it is of paramount importance to consider a holistic approach to comprehend the pathogenesis of SpA in order to identify novel therapeutic targets.<\/jats:p>","DOI":"10.3390\/ijms25116081","type":"journal-article","created":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T06:35:32Z","timestamp":1717137332000},"page":"6081","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Exploring the Pathogenesis of Spondylarthritis beyond HLA-B27: A Descriptive Review"],"prefix":"10.3390","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9750-1203","authenticated-orcid":false,"given":"Ruxandra-Elena","family":"Nagit","sequence":"first","affiliation":[{"name":"Immunology Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8175-2583","authenticated-orcid":false,"given":"Elena","family":"Rezus","sequence":"additional","affiliation":[{"name":"Rheumatology Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"},{"name":"Clinical Rehabilitation Hospital, 700661 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5403-2265","authenticated-orcid":false,"given":"Petru","family":"Cianga","sequence":"additional","affiliation":[{"name":"Immunology Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"},{"name":"Immunology Laboratory, \u201cSt. Spiridon\u201d Clinical Hospital, 700111 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1177\/1759720X18773726","article-title":"Ankylosing spondylitis and axial spondyloarthritis: Recent insights and impact of new classification criteria","volume":"10","author":"Proft","year":"2018","journal-title":"Ther. Adv. Musculoskelet. Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1016\/j.ejim.2011.06.006","article-title":"Extra-articular manifestations of ankylosing spondylitis: Prevalence, characteristics and therapeutic implications","volume":"22","year":"2011","journal-title":"Eur. J. Intern. 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