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Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 1995 Aug;54(8):631–635. doi: 10.1136/ard.54.8.631

IgA1 and IgA2 subclass antibodies against Klebsiella pneumoniae in the sera of patients with peripheral and axial types of ankylosing spondylitis.

O Mäki-Ikola 1, M Nissilä 1, K Lehtinen 1, M Leirisalo-Repo 1, K Granfors 1
PMCID: PMC1009959  PMID: 7677438

Abstract

OBJECTIVE--To study further the Klebsiella specific serum antibody response in patients with axial and peripheral types of ankylosing spondylitis (AS). METHODS--IgA1 and IgA2 subclass antibodies to Klebsiella pneumoniae were measured by enzyme linked immunosorbent assay in the sera of 171 patients with axial or peripheral type AS, and in sera of 100 healthy controls. The effect of 26 weeks of sulphasalazine treatment on the antibody levels in the two types of AS was also analysed. RESULTS--K pneumoniae specific antibody levels of both IgA1 and IgA2 subclasses were increased in the sera of patients with AS compared with healthy controls. The increased levels were present in patients with axial and with peripheral AS, and there were no statistically significant differences in the antibody levels between these two groups. Sulphasalazine treatment decreased the Klebsiella specific antibody level of IgA1 subclass in patients with axial AS, but there were no statistically significant changes in the IgA2 subclass, or in the patients with peripheral type AS. CONCLUSIONS--These results agree with earlier published findings suggesting that IgA (especially Klebsiella specific IgA) may have a role in the pathogenetic mechanisms of both peripheral and axial types of AS. In addition, it seems that both IgA1 and IgA2 subclasses are involved in the disease process.

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Selected References

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  1. André C., André F., Fargier C. Distribution of IgA 1 and IgA 2 plasma cells in various normal human tissues and in the jejunum of plasma IgA-deficient patients. Clin Exp Immunol. 1978 Aug;33(2):327–331. [PMC free article] [PubMed] [Google Scholar]
  2. Collado A., Sanmarti R., Bielsa I., Castel T., Kanterewicz E., Cañete J. D., Brancós M. A., Rotes-Querol J. Immunoglobulin A in the skin of patients with ankylosing spondylitis. Ann Rheum Dis. 1988 Dec;47(12):1004–1007. doi: 10.1136/ard.47.12.1004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Cowling P., Ebringer R., Ebringer A. Association of inflammation with raised serum IgA in ankylosing spondylitis. Ann Rheum Dis. 1980 Dec;39(6):545–549. doi: 10.1136/ard.39.6.545. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Crago S. S., Kutteh W. H., Moro I., Allansmith M. R., Radl J., Haaijman J. J., Mestecky J. Distribution of IgA1-, IgA2-, and J chain-containing cells in human tissues. J Immunol. 1984 Jan;132(1):16–18. [PubMed] [Google Scholar]
  5. Ebringer A. Ankylosing spondylitis is caused by Klebsiella. Evidence from immunogenetic, microbiologic, and serologic studies. Rheum Dis Clin North Am. 1992 Feb;18(1):105–121. [PubMed] [Google Scholar]
  6. Granfors K., Jalkanen S., Lindberg A. A., Mäki-Ikola O., von Essen R., Lahesmaa-Rantala R., Isomäki H., Saario R., Arnold W. J., Toivanen A. Salmonella lipopolysaccharide in synovial cells from patients with reactive arthritis. Lancet. 1990 Mar 24;335(8691):685–688. doi: 10.1016/0140-6736(90)90804-e. [DOI] [PubMed] [Google Scholar]
  7. Granfors K., Jalkanen S., von Essen R., Lahesmaa-Rantala R., Isomäki O., Pekkola-Heino K., Merilahti-Palo R., Saario R., Isomäki H., Toivanen A. Yersinia antigens in synovial-fluid cells from patients with reactive arthritis. N Engl J Med. 1989 Jan 26;320(4):216–221. doi: 10.1056/NEJM198901263200404. [DOI] [PubMed] [Google Scholar]
  8. Granfors K., Toivanen A. IgA-anti-yersinia antibodies in yersinia triggered reactive arthritis. Ann Rheum Dis. 1986 Jul;45(7):561–565. doi: 10.1136/ard.45.7.561. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Hermann E., Yu D. T., Meyer zum Büschenfelde K. H., Fleischer B. HLA-B27-restricted CD8 T cells derived from synovial fluids of patients with reactive arthritis and ankylosing spondylitis. Lancet. 1993 Sep 11;342(8872):646–650. doi: 10.1016/0140-6736(93)91760-j. [DOI] [PubMed] [Google Scholar]
  10. Hocini H., Iscaki S., Benlahrache C., Vitalis L., Chevalier X., Larget-Piet B., Bouvet J. P. Increased levels of serum IgA as IgA1 monomers in ankylosing spondylitis. Ann Rheum Dis. 1992 Jun;51(6):790–792. doi: 10.1136/ard.51.6.790. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Kett K., Brandtzaeg P., Radl J., Haaijman J. J. Different subclass distribution of IgA-producing cells in human lymphoid organs and various secretory tissues. J Immunol. 1986 May 15;136(10):3631–3635. [PubMed] [Google Scholar]
  12. Khan M. A. Pathogenesis of ankylosing spondylitis: recent advances. J Rheumatol. 1993 Aug;20(8):1273–1277. [PubMed] [Google Scholar]
  13. Kirwan J., Edwards A., Huitfeldt B., Thompson P., Currey H. The course of established ankylosing spondylitis and the effects of sulphasalazine over 3 years. Br J Rheumatol. 1993 Aug;32(8):729–733. doi: 10.1093/rheumatology/32.8.729. [DOI] [PubMed] [Google Scholar]
  14. Lahesmaa-Rantala R., Magnusson K. E., Granfors K., Leino R., Sundqvist T., Toivanen A. Intestinal permeability in patients with yersinia triggered reactive arthritis. Ann Rheum Dis. 1991 Feb;50(2):91–94. doi: 10.1136/ard.50.2.91. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Leirisalo-Repo M., Turunen U., Stenman S., Helenius P., Seppälä K. High frequency of silent inflammatory bowel disease in spondylarthropathy. Arthritis Rheum. 1994 Jan;37(1):23–31. doi: 10.1002/art.1780370105. [DOI] [PubMed] [Google Scholar]
  16. MacLean I. L., Archer J. R., Cawley M. I., Kidd B. L., O'Hara B. P., Pegley F. S., Thompson P. W. Immune complexes in ankylosing spondylitis. Ann Rheum Dis. 1992 Jan;51(1):83–86. doi: 10.1136/ard.51.1.83. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Mestecky J. Immunobiology of IgA. Am J Kidney Dis. 1988 Nov;12(5):378–383. doi: 10.1016/s0272-6386(88)80029-5. [DOI] [PubMed] [Google Scholar]
  18. Mestecky J., Russell M. W., Jackson S., Brown T. A. The human IgA system: a reassessment. Clin Immunol Immunopathol. 1986 Jul;40(1):105–114. doi: 10.1016/0090-1229(86)90073-5. [DOI] [PubMed] [Google Scholar]
  19. Mielants H., Veys E. M. The gut in the spondyloarthropathies. J Rheumatol. 1990 Jan;17(1):7–10. [PubMed] [Google Scholar]
  20. Mäki-Ikola O., Granfors K. Salmonella-triggered reactive arthritis. Lancet. 1992 May 2;339(8801):1096–1098. doi: 10.1016/0140-6736(92)90675-s. [DOI] [PubMed] [Google Scholar]
  21. Mäki-Ikola O., Lehtinen K., Granfors K., Vainionpä R., Toivanen P. Bacterial antibodies in ankylosing spondylitis. Clin Exp Immunol. 1991 Jun;84(3):472–475. [PMC free article] [PubMed] [Google Scholar]
  22. Mäki-Ikola O., Lehtinen K., Nissilä M., Granfors K. IgM, IgA and IgG class serum antibodies against Klebsiella pneumoniae and Escherichia coli lipopolysaccharides in patients with ankylosing spondylitis. Br J Rheumatol. 1994 Nov;33(11):1025–1029. doi: 10.1093/rheumatology/33.11.1025. [DOI] [PubMed] [Google Scholar]
  23. Mäki-Ikola O., Leirisalo-Repo M., Kantele A., Toivanen P., Granfors K. Salmonella-specific antibodies in reactive arthritis. J Infect Dis. 1991 Dec;164(6):1141–1148. doi: 10.1093/infdis/164.6.1141. [DOI] [PubMed] [Google Scholar]
  24. Nissilä M., Lahesmaa R., Leirisalo-Repo M., Lehtinen K., Toivanen P., Granfors K. Antibodies to Klebsiella pneumoniae, Escherichia coli, and Proteus mirabilis in ankylosing spondylitis: effect of sulfasalazine treatment. J Rheumatol. 1994 Nov;21(11):2082–2087. [PubMed] [Google Scholar]
  25. Nissilä M., Lehtinen K., Leirisalo-Repo M., Luukkainen R., Mutru O., Yli-Kerttula U. Sulfasalazine in the treatment of ankylosing spondylitis. A twenty-six-week, placebo-controlled clinical trial. Arthritis Rheum. 1988 Sep;31(9):1111–1116. doi: 10.1002/art.1780310905. [DOI] [PubMed] [Google Scholar]
  26. O'Mahony S., Anderson N., Nuki G., Ferguson A. Systemic and mucosal antibodies to Klebsiella in patients with ankylosing spondylitis and Crohn's disease. Ann Rheum Dis. 1992 Dec;51(12):1296–1300. doi: 10.1136/ard.51.12.1296. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. O'Mahony S., Ferguson A. Small intestinal mucosal protection mechanisms and their importance in rheumatology. Ann Rheum Dis. 1991 May;50(5):331–336. doi: 10.1136/ard.50.5.331. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Peeters A. J., Daha M. R., Smeets T. J., Breedveld F. C. Bone marrow IgA and IgA subclass synthesis in ankylosing spondylitis. J Rheumatol. 1992 May;19(5):751–753. [PubMed] [Google Scholar]
  29. Peeters A. J., van den Wall Bake A. W., van Dalsen A. D., Westedt M. L. Relation of microscopic haematuria in ankylosing spondylitis to circulating IgA containing immune complexes. Ann Rheum Dis. 1988 Aug;47(8):645–647. doi: 10.1136/ard.47.8.645. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Shodjai-Moradi F., Ebringer A., Abuljadayel I. IgA antibody response to klebsiella in ankylosing spondylitis measured by immunoblotting. Ann Rheum Dis. 1992 Feb;51(2):233–237. doi: 10.1136/ard.51.2.233. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Smith M. D., Gibson R. A., Brooks P. M. Abnormal bowel permeability in ankylosing spondylitis and rheumatoid arthritis. J Rheumatol. 1985 Apr;12(2):299–305. [PubMed] [Google Scholar]
  32. Trull A. K., Panayi G. S. Serum and secretory IgA immune response to Klebsiella pneumoniae in ankylosing spondylitis. Clin Rheumatol. 1983 Dec;2(4):331–337. doi: 10.1007/BF02041551. [DOI] [PubMed] [Google Scholar]

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