Iga Antibodies to Klebsiella Pneumoniae in Ankylosing Spondylitis

Abstract

Serum IgA antibodies to Klebsiella pneumoniae were measured in 65 patients with ankylosing spondylitis (AS) during different phases of disease activity and compared with the antibody level in 21 psoriatic arthritis (PsA) patients, 43 rheumatoid arthritis (RA) patients and 57 healthy controls. The mean IgA antibody to Klebsiella in AS patients with an erythrocyte sedimentation rate (ESR) greater than or equal to 15 mm/h was significantly higher than the antibody level in patients with an ESR less than 15 mm/h (p less than 0.02) and tended to increase with rising ESR. There was a significant difference in anti-Klebsiella antibody levels between AS patients with an elevated ESR and antibody levels in PsA patients (p less than 0.001), RA patients (p less than 0.001) and healthy controls (p less than 0.005). There was no difference between healthy controls and patients with PsA, RA or AS patients with a low ESR. The IgA anti-Klebsiella antibody was specifically absorbed out from sera with inactivated klebsiella pneumoniae organisms. Antibody levels to Candida albicans and Escherichia coli did not differ in patients vis-à-vis control subjects. The mean serum anti-Klebsiella IgA level was found to be higher in patients who were either clinically active or had positive faeval cultures, when compared with patients with inactive disease and negative cultures, but these differences were not statistically significant, although when both parameters were examined together a significant additive effect was detected (p less than 0.001). It is concluded that patient with AS exhibit a specific elevation of serum IgA antibody to Klebsiella antigen.

Correlation of immunoglobulin and C reactive protein levels in ankylosing spondylitis and rheumatoid arthritis.

“…The ESR is notoriously unreliable as an Accepted for publication 29 indicator of disease activity in AS.8 CRP levels have been found to correlate with the activity of the peripheral arthritis and not the spondylitis in AS.91' A recent study, however, has shown that CRP levels as assessed quantitatively by nephelometry were extremely sensitive indicators of overall disease activity in AS. 12 Raised levels of IgG, IgA, and IgM also occur in AS but probably do not correlate with disease activity.…”

HLA molecules, bacteria and autoimmunity

“…However, there were no signi®cant elevations of antibody levels against Escherichia coli and Candida albicans in any of the ®ve groups examined [46]. In a second study, we reported an elevation in mean titre of anti-Klebsiella antibodies in 24 active AS patients, whereas no such elevation was found in 28 inactive AS patients, 30 RA patients and 41 healthy control subjects [47].…”

Antibody to a 63 kilodalton insect protein in ankylosing spondylitis.

“…Increased levels of serum IgA are well recognised in some patients, autoantibodies to HLA-B27 have been reported,2 and antibodies to bacteria have been studied. 3 There is one report of a specific antibody response in AS, directed at heat shock puffs of Drosophila melanogaster larvae. 4 Heat shock, warming cells a few degrees above their physiological temperature, and various other physical and chemical stresses cause a reduction in the synthesis of many cellular proteins and increased synthesis of the so called heat shock or stress proteins.…”