The diagnosis of psoriatic arthritis (PsA) is frequently delayed due to variable clinical presentations and the lack of specific biomarkers. Genetic susceptibility, environmental triggers, and immune system dysregulation—particularly via the IL-23/Th17 pathway—contribute to disease onset and progression. Biologic and small-molecule therapies targeting TNF-α, IL-17, IL-23, and JAK pathways have significantly improved patient outcomes by reducing inflammation and preventing joint damage.

Mounting evidence also links gut microbiota dysbiosis with PsA development. Studies show that patients with PsA have reduced microbial diversity and lower levels of butyrate-producing bacteria such as Faecalibacterium and Akkermansia, which help maintain gut integrity and immune balance. Dysbiosis may contribute to systemic inflammation and immune dysfunction, potentially triggering or worsening PsA. Microbiota-focused interventions—probiotics, prebiotics, fecal microbiota transplantation (FMT), phage therapy, and dietary changes—are under investigation as adjunctive treatments. While early results are encouraging, more research is needed to determine their safety, efficacy, and role in personalized PsA care.

Reference: Bonomo MG, D’Angelo S, Picerno V, et al. Recent Advances in Gut Microbiota in Psoriatic Arthritis. Nutrients. 2025 Apr 11;17(8):1323. doi: 10.3390/nu17081323. PMID: 40284188; PMCID: PMC12030176.