Ankylosing spondylitis is linked to Klebsiella—the evidence

  title={Ankylosing spondylitis is linked to Klebsiella—the evidence},
  author={Taha M. Rashid and Alan Ebringer},
  journal={Clinical Rheumatology},
Ankylosing spondylitis (AS) is a chronic inflammatory spinal and large-joint arthritic and potentially disabling condition, mainly affecting males of young age groups. Extensive literature based on the results of various genetic, microbiological, molecular and immunological studies carried out by independent research groups suggests that Klebsiella pneumoniae is the main microbial agent being implicated as a triggering and/or perpetuating factor in the etiopathogenesis of AS. Novel diagnostic… 
Immunopathogenesis of Ankylosing Spondylitis: An Updated Review
The present study summarizes the current literature on the immunogenetics of AS and contemporize the research advancement that has been made over the past decade.
Ankylosing spondylitis: etiology, pathogenesis, and treatments
The current study reviewed the etiology and pathogenesis of AS, including genome-wide association studies and cytokine pathways, and summarized the current pharmaceutical and surgical treatment with a discussion of future potential therapies.
The Link between Ankylosing Spondylitis, Crohn's Disease, Klebsiella, and Starch Consumption
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.
The pathogenesis of ankylosing spondylitis.
An improved understanding of the sequence of molecular events that predispose and initiate the onset of this disease will allow for more specific and targeted therapy and better avoidance of the significant side effects of systemic immunomodulation.
Pathogenesis of ankylosing spondylitis
This Review outlines the key areas of current research in this field, describes several hypotheses regarding the pathogenesis of AS, which are under intense investigation, and concludes with a dissection of the processes involved in bone erosion and syndesmophyte formation.
Advances in nanomedicine for the treatment of ankylosing spondylitis
This review work focuses on the more promising nanomedicine-based treatment modalities to move this field forward in ankylosing spondylitis.
Usefulness of complex bacteriological and serological analysis in patients with spondyloarthritis
The detection of anti-bacterial antibodies combined with other specific laboratory investigations should be more extensively used to monitor SpA patients in association with their symptoms and in order to determine and administer more effective therapeutics.
The immunopathogenesis of ankylosing spondylitis
The first characterisations of the phenotype and functions of DCs and other myeloid populations purified directly from AS patients are performed, to understand their role in AS pathogenesis and indicate that APCs of mucosal origin may make a significant contribution to the systemic inflammation observed in AS patients.
The genomics and genetics of ankylosing spondylitis
Although some common genes/pathways have been identified, overall the results to date have been somewhat disappointing due to differences in experimental design and tissue source as well as the low power of the studies.
Genetics and genomics of ankylosing spondylitis
Genomic and proteomic studies have shown that there is a strong genetic overlap between AS and Crohn’s disease in particular, although there are also major differences in the genes involved in the two conditions, presumably explaining their different presentations.


Ankylosing spondylitis is caused by Klebsiella. Evidence from immunogenetic, microbiologic, and serologic studies.
  • A. Ebringer
  • Medicine, Biology
    Rheumatic diseases clinics of North America
  • 1992
It is suggested that therapeutic trials should be set up with the aim of eliminating Klebsiella microbes, in an endeavor to test the validity of this theory.
Ankylosing Spondylitis, HLA-B27 and Klebsiella - An Overview: Proposal for Early Diagnosis and Treatment
It is suggested that identifying and treating patients with Klebsiella reactive arthritis/pre-AS could involve the use of anti- KlebsIElla measures, such as antibiotics and low starch diet together with immunosuppressive drugs in an endeavour to prevent the irreversible sequelae of established AS.
Faecal flora in spondyloarthropathy.
There was no increased isolation rate of Klebsiella or other proposed arthritogenic organism in those with spondyloarthropathy and its presence was not related to disease activity, the erythrocyte sedimentation rate or C-reactive protein.
Genetic susceptibility to ankylosing spondylitis.
Methods for genetic investigation of ankylosing spondylitis are described, the status of current research in this exciting area is summarized, and there is compelling evidence that non-B27 genes, both within and outwith the major histocompatability complex, are involved in disease aetiology.
Ankylosing spondylitis: klebsiella and HL-A B27.
A search for the presence of Klebsiella-Enterobacter spp. and Yersinia enterocolitica in urine and faeces of 63 patients with ankylosing spondylitis was conducted because these microorganisms have
No conclusive evidence of an epidemiological relation between Klebsiella and ankylosing spondylitis.
In the patient group no temporal relation could be found between activity of the disease and the presence of Klebsiella in the intestinal tract and in a dynamic study changes in Klebsies quantity over a period of 3 months were compared with changes in disease activity over the same period.
Klebsiella pneumoniae and acute anterior uveitis in ankylosing spondylitis.
Evidence of a cross-reactivity among three Gramnegative micro-organisms-Enterobacter aerogenes, Klebsiella pneumoniae, and Yersinia entercolitica-and HLA B27 positive lymphocytes is reported and it is found that Kl pneumoniae was found more frequently in AS patients with active disease than in controls or patients with inactive disease.
Frequency of faecal Klebsiella aerogenes in patients with ankylosing spondylitis and controls with respect to individual features of the disease.
The results suggest that K. aerogenes may have an aetiological role in the development of non-granulomatous anterior uveitis and peripheral arthritis in patients with ankylosing spondylitis but do not lend support to this organism having such a role inThe spinal disease itself.
Antibodies to Klebsiella and Proteus microorganisms in ankylosing spondylitis and rheumatoid arthritis patients measured by ELISA.
Antibodies to Klebsiella oxytoca and Proteus mirabilis in 21 active ankylosing spondylitis (AS), 13 active rheumatoid arthritis (RA), 19 inactive RA patients and 18 healthy controls were measured
Ileocolonoscopic findings in seronegative spondylarthropathies.
Some of the patients with seronegative spondylarthropathies suffer from a subclinical form of Crohn's disease of which the joint symptoms are the unique clinical manifestation, support for this hypothesis was provided by the results of a repeat ileocolonoscopy, disclosing a strong association between the presence of gut inflammation on biopsy and the persistence of joint inflammation.