Spondyloarthritis and the gut: A new look

Wendling, Daniel; Vuitton, Lucine; Koch, Stéphane; Prati, Clément

doi:10.1016/j.jbspin.2014.12.004

Cited by 13 publications

(7 citation statements)

References 24 publications

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“…attempted to address these issues with a combined human/rabbit study. The human component showed growth in only three of 30 discs (cultured for 10 days), none P. acnes ; the rabbits verified that “ P. acnes could infect the degenerated lumbar discs by way of bacteremia.” 39 Finally, a recent editorial addressing the present understanding of spondyloarthritis and gut microbiota noted that evaluating, and trying to modulate gut microbiota is a very complex undertaking; however, various rheumatologic conditions may be associated with distinct bacterial profiles 40 …”

Section: Discussionmentioning

confidence: 99%

Propionibacterium acnes, Coagulase-Negative Staphylococcus, and the “Biofilm-like” Intervertebral Disc

Coscia

Denys

Wack

2016

Spine

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Study Design.Patients scheduled for spinal surgery were screened prospectively for a microbial presence associated with intervertebral disc specimens. Inclusion was limited to patients requiring surgery for any of five conditions: study patients with cervical spine intervertebral herniation (IVH), lumbar spine IVH, lumbar spine discogenic pain, and control patients with idiopathic scoliosis/Scheurermann's kyphosis or trauma/neuromuscular deformity. Exclusion criteria included ongoing systemic infection, abnormal pre-operative white cell counts, documented or suspected spinal infection, or previous surgery to the involved disc.Objective.The aim of this study was to test for an association between the presence of a bacterial entity in operated discs and a diagnosis of pathologic disc disease.Summary of Background Data.An association has been described between microbial colonization and progressive intervertebral disc degeneration in 36 herniation patients undergoing microdiscectomies. A total of 19 patients had positive cultures on long-term incubation, with Propionibacterium acnes present in 84% of discs.Materials and Methods.Discs were harvested during surgery, using strict sterile technique. Each disc was divided, with half the sample sealed in a sterile, commercially prepared anaerobic culture transport container, and half fixed in formalin. Live specimens were cultured for bacteria at a university-affiliated laboratory in a blinded fashion. Fixed pathologic specimens were gram-stained and read by a board-certified pathologist.Results.A total of 169 intervertebral discs from 87 patients were evaluated (46 males, 41 females). Positive cultures were noted in 76 of 169 discs (45%), with 34 discs positive for P. acnes and 30 discs positive for Staphylococcus. No pathologic evidence was seen of microorganisms, acute or chronic inflammation, or infection. Pooling the IVH and discogenic pain patients and contrasting them with control patients showed a significant association of IVH with positive bacterial cultures (χ 2 = 15.37; P = 0.000088).Conclusion.Endemic bacterial biofilms are significantly associated with IVH and discogenic pain. Level of Evidence: N/A

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Section: Discussionmentioning

confidence: 99%

Propionibacterium acnes, Coagulase-Negative Staphylococcus, and the “Biofilm-like” Intervertebral Disc

Coscia

Denys

Wack

2016

Spine

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“…The presence of (microscopic) gut inflammation appears relevant for prognosis and therapeutic decision making as SpA patients with a chronic type of gut inflammation have a less favourable disease course. Therefore, faecal calprotectin analysis is part of the clinical diagnostic work-up of SpA patients [28]. In our study, 26 consecutive rheumatologic patients (24.8%) were included.…”

Section: Methodsmentioning

confidence: 99%

Analytical performance and diagnostic accuracy of six different faecal calprotectin assays in inflammatory bowel disease

Oyaert

Boel

Jacobs

et al. 2017

Clinical Chemistry and Laboratory Medicine (CCLM)

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Background: We evaluated the analytical performance of six different faecal calprotectin immunoassays together with their diagnostic accuracy in the discrimination between functional and organic bowel disorders. Methods: The faecal samples were obtained from inflammatory bowel disease patients (n = 27) at the time of diagnosis [Crohn's disease (n = 15), colitis ulcerosa (n = 12)], gastroenterologic disease control patients (n = 52) and rheumatologic disease control patients (n = 26). All individuals included in the study underwent a concurrent ileocolonoscopy. Analytical performance (imprecision, accuracy, carry-over, correlation and agreement) and diagnostic accuracy (sensitivity, specificity, likelihood ratios) of the different assays were evaluated. Results: All methods demonstrated good analytical performance, but within-run and total imprecision varied depending on the assay methodology used. Using Passing Bablok and Bland-Altman analyses, low quantitative agreement was observed between the assays. All assays showed excellent diagnostic accuracy, with areas under the receiver operating characteristic curves (ROC) ranging from 0.974 to 0.998. The AUCs were not significantly different between assays (p > 0.05). Diagnostic sensitivity at the

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“…In the same way, the impact of this treatment on extra rheumatologic manifestations is important, since they are part of the general presentation of the disease. In non-AS patients, secukinumab showed beneficial effect on uveitis (with high doses) [10], and on skin psoriasis [11]; but the results in Crohn's disease were disappointing [12], even if there are clear connections between gut inflammation and axial spondyloarthritis [13].…”

Section: Daniel Wendlingmentioning

confidence: 99%