Association between food allergy and ankylosing spondylitis

Abstract

Food allergies can alter the gut microbiome composition, increasing the risk of conditions such as ankylosing spondylitis (AS). To identify the association between specific allergens and AS, we investigated the differences in the serum levels of 14 food antigen-specific immunoglobulin (Ig) G between AS patients and healthy participants. The association between the levels of these antibodies and disease activity was assessed by measuring the inflammatory marker C-reactive protein (CRP). We enrolled 75 AS patients and 78 healthy controls who had undergone antigen-specific IgG tests in West China Hospital between January 2015 and October 2017, and performed enzyme-linked immunosorbent assays for specific IgG against 14 food allergens: rice, egg, mushroom, milk, pork, chicken, beef, crab, codfish, corn, soybean, tomato, shrimp, and wheat. The following tests were used to analyze differences between AS patients and healthy controls: χ 2 test for sex, and a 2-tailed Student t -test or Mann–Whitney U test based on the results of Levene test for age and IgG levels. Correlations between IgG and CRP levels were calculated using a Spearman's correlation. AS patients had significantly higher serum levels of beef-, crab-, and pork-specific IgG than did healthy participants. In addition, the serum levels of pork-specific IgG were significantly and positively correlated with CRP. These results suggest that α-Gal, the predominant natural antigen in mammalian red meat, might play a potential role in the pathogenesis of AS, and therefore, AS patients should exclude such allergenic foods, including beef, crab and pork, from their daily diet.

Lifestyle modification and inflammation in people with axial spondyloarthropathy—A scoping review

“…As disease activity varies substantially with AS, an interaction between poor diet and inflammation of the gastrointestinal tract may correlate with severe disease activity (Hascelik et al., 2009). In support, observational research highlighted that patients with AS had higher levels of pork‐specific immunoglobulins than healthy controls, and this was positively associated with CRP concentrations (Niu et al., 2019). However, as with PA studies, the cross‐sectional nature of much of the research into diet modification in patients with AS does not allow determination of cause and effect.…”

“…In support, observational research highlighted that patients with AS had higher levels of pork-specific immunoglobulins than healthy controls, and this was positively associated with CRP concentrations (Niu et al, 2019) A high omega-3 fatty acid diet compared to one that was low (4.55 vs. 1.95 g omega-3/day for ∼ 5 months) was significantly more effective at improving BASDAI, but this study was potentially confounded by age, symptom duration, and disease duration, all of which were higher in the low omega-3 dose group (Sundström et al, 2006). Two studies found no significant effect of probiotics on patient reported outcome measures.…”

Role of the microbiome and its metabolites in ankylosing spondylitis

“…Because of the evidence, this diet seems promising as a possible strategy for addressing AS. In addition, α-Gal, a food allergen, is the leading natural antigen in mammalian red meat and may be involved in the pathogenesis of AS ( 212 ). On this account, allergenic foods such as beef, crab, and pork should be excluded from the daily diet of AS patients.…”