HLA-B27-associated gut microbiota and amino acid perturbations promote ankylosing spondylitis through M1 macrophage activation.

At the functional level (KO genes), the symptomatic subgroup showed a decreasing trend for trpF (in tryptophan metabolism) and a significant increase for cuyA (in cysteine metabolism), alongside significant alterations in ilvH and lysA (Figure S9C).

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Clinically, disease activity scores showed a trend toward being higher in patients with gastrointestinal symptoms (Figure S9A).

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