Increased Recovery of Klebsiella from the Gastrointestinal Tract of Reiter's Syndrome and Ankylosing Spondylitis Patients

Kuberski, Timothy T.; Morse, Harold G.; Rate, Robert G.; Bonnell, Mark D.

doi:10.1093/rheumatology/xxii.suppl_2.85

Cited by 34 publications

(11 citation statements)

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“…Another group from Germany had found that among four Klebsiella isolates and 42 different serotypes, only Klebsiella oxytoca could be isolated significantly more often in the faeces of patients with AS when compared to those with osteoporosis and rheumatoid arthritis [62]. Two other groups have also found an increased isolation of Klebsiella in the faecal cultures from active AS patients whether these patients were identified by high CRP levels [63], or defined clinically [64], but others could not find such an association [65][66][67]. These conflicting results could be due to different methods used for the collection and culture of the faecal specimens, and whether the samples were obtained during active or inactive stages of the disease.…”

Section: Gut As the Main Source Of Klebsiella Infection In "As"mentioning

confidence: 99%

Ankylosing Spondylitis, HLA-B27 and Klebsiella - An Overview: Proposal for Early Diagnosis and Treatment

Ebringer¹,

Rashid²,

Wilson³

et al. 2006

CRR

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Ankylosing spondylitis (AS) is a potentially disabling rheumatic disease for which no curative treatment has yet been discovered.An extensive computer-based and manual search was undertaken to evaluate the role of microbes in the pathogenesis of AS. All together 147 papers were scrutinised. A total of 24 studies carried out on 1330 AS patients and 1191 healthy controls involving 15 different countries showed significantly elevated Klebsiella antibodies in AS patients when compared to controls. Molecular analysis has shown that Klebsiella microbes possess antigens, which cross-react with self-antigens, such as HLA-B27 and spinal collagens.Diagnostic criteria have been developed in which a person who is HLA-B27 positive and has clinical and laboratory evidence of an inflammatory backache for at least three months is proposed to have pre-AS. A specific elevation of antiKlebsiella antibodies would confirm the diagnosis. A proposal for an early treatment using anti-Klebsiella measures is suggested.So far, apart from Klebsiella no other microbes have been shown to have a link with the development of AS. It is suggested that identifying and treating patients with Klebsiella reactive arthritis/pre-AS could involve the use of antiKlebsiella measures, such as antibiotics and low starch diet together with immunosuppressive drugs in an endeavour to prevent the irreversible sequelae of established AS.

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Section: Gut As the Main Source Of Klebsiella Infection In "As"mentioning

confidence: 99%

Ankylosing Spondylitis, HLA-B27 and Klebsiella - An Overview: Proposal for Early Diagnosis and Treatment

Ebringer¹,

Rashid²,

Wilson³

et al. 2006

CRR

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“…Several groups have confirmed the finding of an elevated fecal carriage oi Klebsiella pneumoniae in active AS , Kuberski et al 1981, Eastmond et al 1982, and increased IgA antibodies against this gramnegative enterobacterium have been detected in AS sera (Trull et al 1984). The cross-tolerance hypothesis which relates the pathogenesis of AS to certain enterobacteriaceae cross-reacting with HLA-B27 , Ebringer 1983 has recently found strong van Bohemen et al (1984) who reported the identification of HLA-B27 cross-reactive antigens in Shigella fiexneri, Yersinia enterocolitica and Klebsiella pneumoniae.…”

Section: Bacterial Antibodies and Asmentioning

confidence: 88%

HLA‐B27 and Clinical Aspects of Ankylosing Spondylitis: Results of Prospective Studies

Wagener

Mau

Zeidler

et al. 1985

Immunological Reviews

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“…Klebsiella bacteria have been isolated by different independent groups more significantly from the bowel of active AS patients when compared to controls [39–42]. These findings, however, were not confirmed by other groups [43, 44].…”

Section: Evidence Of Subclinical Microbial Infections In As and CDmentioning

confidence: 97%

The Link between Ankylosing Spondylitis, Crohn’s Disease,Klebsiella, and Starch Consumption

Rashid

Wilson

Ebringer

2013

Clinical and Developmental Immunology

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Both ankylosing spondylitis (AS) and Crohn's disease (CD) are chronic and potentially disabling interrelated conditions, which have been included under the group of spondyloarthropathies. The results of a large number of studies support the idea that an enteropathic pathogen, Klebsiella pneumoniae, is the most likely triggering factor involved in the initiation and development of these diseases. Increased starch consumptions by genetically susceptible individuals such as those possessing HLA-B27 allelotypes could trigger the disease in both AS and CD by enhancing the growth and perpetuation of the Klebsiella microbes in the bowel. Exposure to increased levels of these microbes will lead to the production of elevated levels of anti-Klebsiella antibodies as well as autoantibodies against cross-reactive self-antigens with resultant pathological lesions in the bowel and joints. Hence, a decrease of starch-containing products in the daily dietary intake could have a beneficial therapeutic effect on the disease especially when used in conjunction with the currently available medical therapies in the treatment of patients with AS and CD.

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Increased Recovery of Klebsiella from the Gastrointestinal Tract of Reiter's Syndrome and Ankylosing Spondylitis Patients

Cited by 34 publications

References 0 publications

Ankylosing Spondylitis, HLA-B27 and Klebsiella - An Overview: Proposal for Early Diagnosis and Treatment

Ankylosing Spondylitis, HLA-B27 and Klebsiella - An Overview: Proposal for Early Diagnosis and Treatment

HLA‐B27 and Clinical Aspects of Ankylosing Spondylitis: Results of Prospective Studies

The Link between Ankylosing Spondylitis, Crohn’s Disease,Klebsiella, and Starch Consumption

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