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The gut–joint axis in the pathogenesis of IBD and SpA/PsA. Immunological changes in the gut–joint axis: genetic predisposition, environmental factors, and dysbiosis contribute to the loss of intestinal permeability, with consequent activation of immune cells and production of cytokines (i.e., TNF, IL-23, and IL-17), which stimulate chronic inflammation and migration of leukocytes from the gut toward the joints.
