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Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 1997 Mar;56(3):180–183. doi: 10.1136/ard.56.3.180

Association of gut inflammation with increased serum IgA class Klebsiella antibody concentrations in patients with axial ankylosing spondylitis (AS): implication for different aetiopathogenetic mechanisms for axial and peripheral AS?

O Maki-Ikola 1, M Leirisalo-Repo 1, U Turunen 1, K Granfors 1
PMCID: PMC1752347  PMID: 9135221

Abstract

OBJECTIVES—A role for Klebsiella pneumoniae in ankylosing spondylitis (AS) has been suggested because faecal carriage of Klebsiella and serum Klebsiella specific antibodies may be increased in this disease. This study has extended the earlier findings by comparing Klebsiella specific serum IgA class antibodies with inflammatory changes in the gut.
METHODS—IgA antibodies to K pneumoniae, Escherichia coli, and Proteus mirabilis in serum samples of 25 patients with AS, of eight control patients, and of 100 healthy blood donors were measured by enzyme immunoassay. Gut inflammation of the patients was studied by ileocolonoscopy.
RESULTS—Increased IgA antibody concentrations to K pneumoniae associated with gut inflammation in patients with axial form of AS. Such association was not seen in patients with peripheral form of AS.
CONCLUSIONS—These findings may provide further evidence for the role of K pneumoniae in the pathogenesis of AS. However, at least some of the patients with axial AS without gut inflammation, as well as patients with peripheral AS did not have increased K pneumoniae antibody concentrations, which may be regarded as evidence against the direct role of K pneumoniae in the pathogenesis. The aetiopathogenetic mechanisms in the axial and peripheral form of AS may be different.



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Figure 1  .

Figure 1  

IgA class antibody concentrations to Klebsiella pneumoniae in serum samples of patients with axial type of ankylosing spondylitis, grouped according to ileocolonoscopic findings. Results for the control patients with other rheumatic diseases and healthy controls are also shown. p Values are given when compared with the healthy controls. The dashed line shows the antibody value for mean (2 SD) of the healthy blood donors. EIU, enzyme immunoassay unit. Median values for each subgroup have been marked with horizontal lines.

Figure 2  .

Figure 2  

IgA class antibody concentrations to Klebsiella pneumoniae in serum samples of patients with peripheral type of ankylosing spondylitis, grouped according to ileocolonoscopic findings. Results for the control patients with other rheumatic diseases and healthy controls are also shown. The dashed line shows the antibody value for mean (2 SD) of the healthy blood donors. EIU, enzyme immunoassay unit. Median values for each subgroup have been marked with horizontal lines.


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