Rare occurrence of inflammatory bowel disease in a cohort of Han Chinese ankylosing spondylitis patients- a single institute study

Wang, Chrong‐Reen; Weng, Chih‐Huang; Huang, Kuo Yuan; Hsu, Sheng Min; Liu, Ming Fei

doi:10.1038/s41598-017-13573-z

Cited by 12 publications

(9 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a study involving 988 patients with ankylosing spondylitis in east Asia, only 0.4% developed inflammatory bowel disease. 1 However, in some analyses performed in Western countries, ~5%–10% of patients with AS present with inflammatory bowel disease. 2,3…”

Section: Introductionmentioning

confidence: 99%

Ankylosing spondylitis: etiology, pathogenesis, and treatments

et al. 2019

View full text Add to dashboard Cite

Ankylosing spondylitis (AS), a common type of spondyloarthropathy, is a chronic inflammatory autoimmune disease that mainly affects spine joints, causing severe, chronic pain; additionally, in more advanced cases, it can cause spine fusion. Significant progress in its pathophysiology and treatment has been achieved in the last decade. Immune cells and innate cytokines have been suggested to be crucial in the pathogenesis of AS, especially human leukocyte antigen (HLA)‑B27 and the interleukin‑23/17 axis. However, the pathogenesis of AS remains unclear. The current study reviewed the etiology and pathogenesis of AS, including genome-wide association studies and cytokine pathways. This study also summarized the current pharmaceutical and surgical treatment with a discussion of future potential therapies.

show abstract

Section: Introductionmentioning

confidence: 99%

Ankylosing spondylitis: etiology, pathogenesis, and treatments

et al. 2019

View full text Add to dashboard Cite

show abstract

“…reported that the occurrence of IBD in Han Chinese patients with AS was rare. ( 5 ) Therefore, we examined the IBD risk in Taiwanese patients with AS using the large Taiwan National Health Insurance Research Database (NHIRD) and compared the risk in patients with AS with that in matched comparison cohort patients without AS.…”

Section: Introductionmentioning

confidence: 99%

Increased Risk of Inflammatory Bowel Disease Among Patients With Ankylosing Spondylitis: A 13-Year Population-Based Cohort Study

et al. 2020

View full text Add to dashboard Cite

Aim Ankylosing spondylitis (AS) primarily affects the axial skeleton and extraarticular structures. Small-scaled studies have reported that the incidence and prevalence of inﬂammatory bowel disease (IBD) are higher in patients with AS than in the general population. This study determined the incidence of IBD in patients with AS using a large scale population-based cohort dataset. Methods This was a retrospective cohort study. Patient data were collected from the Taiwan National Health Insurance Research Database from 2000 to 2012. We enrolled 3,804 patients with AS and 7,608 non-AS patients. The endpoint was IBD diagnosis by using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) coding 555 and 556 after at least three outpatient visits or one hospital admission, until the end of 2012. The Kaplan–Meier analysis was performed to discriminate the cumulative incidence of IBD and the log-rank test was used to test the significance. A Cox proportional hazard model was used to estimate the hazard ratio (HR) for IBD between the AS and non-AS groups. Results Among the population as a whole the Cox proportional hazard regression indicated that patients aged ≥65 years [adjusted HR (aHR): 2.48, 95% confidence interval (CI): 1.38–4.47] or with comorbidity of cancer (aHR: 3.51, 95% CI: 1.40–8.80) had a higher HR for IBD. Kaplan–Meier curves of cumulative incidence proportion of IBD indicated that patients with AS had a higher risk of IBD than the non-AS group in the subgroup aged <40 years (HR: 2.85, 95% CI: 1.51–5.40, p = 0.001). Conclusions Patients with AS aged <40 years had a higher IBD risk than did those without AS in Taiwan. Clinicians and patients should be aware of this association.

show abstract

“…Despite the supposition that gut and joint inflammation in SpA are intricately linked, there are salient findings that are not consistent with the hypothesis. One issue, as highlighted in the above discussion, is that the gut-joint paradigm in SpA is based on studies in cohorts of patients of European descent, but IBD is rarely comorbid in patients with SpA who are of East Asian descent: in a 2017 study of 988 Han Chinese patients with axSpA, only four patients (0.4%) had IBD, specifically ulcerative colitis 51 , and a 2019 study of the Taiwanese national health registry Box 1 | SpA and its subtypes Historically, spondyloarthritis (spA) was classified by the pattern of articular and extra-articular symptoms. Ankylosing spondylitis (As) was identified primarily using the 1984 modified New York criteria, which specifically focused on radiographic changes to the sacroiliac joint 259 .…”

Section: Reading Between the Linksmentioning

confidence: 99%

Revisiting the gut–joint axis: links between gut inflammation and spondyloarthritis

et al. 2020

View full text Add to dashboard Cite

Gut inflammation is strongly associated with spondyloarthritis (SpA), as exemplified by the high prevalence of inflammatory bowel disease (IBD) and the even higher occurrence of subclinical gut inflammation in patients with SpA. The gut-joint axis of inflammation in SpA is further reinforced by similarities in immunopathogenesis at both anatomical sites and by the clinical success of therapies blocking TNF and IL-23 in IBD and in some forms of SpA. Many genetic risk factors are shared between SpA and IBD, and changes in the composition of gut microbiota are seen in both diseases. Current dogma is that inflammation in SpA initiates in the gut and leads to joint inflammation; however, although conceptually attractive, some research does not support this causal relationship. For example, therapies targeting IL-17A are efficacious in the joint but not the gut, and interfering with gut trafficking by targeting molecules such as α4β7 in IBD can lead to onset or flares of SpA. Several important knowledge gaps remain that must be addressed in future studies. Determining the true nature of the gut-joint axis has real-world implications for the treatment of patients with co-incident IBD and SpA and for the repurposing of therapeutics from one disease to the other.

show abstract

Rare occurrence of inflammatory bowel disease in a cohort of Han Chinese ankylosing spondylitis patients- a single institute study

Cited by 12 publications

References 40 publications

Ankylosing spondylitis: etiology, pathogenesis, and treatments

Ankylosing spondylitis: etiology, pathogenesis, and treatments

Increased Risk of Inflammatory Bowel Disease Among Patients With Ankylosing Spondylitis: A 13-Year Population-Based Cohort Study

Revisiting the gut–joint axis: links between gut inflammation and spondyloarthritis

Contact Info

Product

Resources

About