Call for a More Nuanced Understanding of the Gut-Joint Axis for Arthritis
Some arthritis is associated with intestinal inflammation and other digestive problems. The gut-joint axis hypothesis suggests a link between gut inflammation and joint inflammation, but some arthritis develops in the absence of gut inflammation, and studies have not yet established a causal relationship. In a March 2025 article published in Trends in Immunology, researchers review the evidence for the gut-joint hypothesis and propose a more nuanced relationship between gut inflammation, arthritis and immune hypersensitivity, which is an overactive immune response that can damage healthy tissue. The authors propose an “immune hypersensitivity hypothesis”—that some arthritis subtypes are influenced by the gut, while others are driven by joint-specific mechanisms independent from gut inflammation. The researchers call for nuanced understanding that recognizes that the gut-joint connection may not be consistent across all forms of arthritis. They conclude that interplay among genetics, environmental triggers and immune hypersensitivity contribute to development of gut and joint inflammation.
