A possible link between Crohn's disease and ankylosing spondylitis via Klebsiella inf

[Mazen]

This is interesting and it proposes use of antibiotics and low starch diet (like SCD)


http://www.ncbi.nlm.nih.gov/pubmed/16941202?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=5&log$=relatedarticles&logdbfrom=pubmed

Crohn's disease (CD) is an immune-mediated gastrointestinal inflammatory disease, which could arise from an interplay between genetic and environmental factors. Klebsiella microbes were suggested to have a vital role in the initiation and perpetuation of the disease through the mechanism of molecular mimicry. This proposition is based on the results of various studies where significantly elevated levels of antibodies against the whole bacteria or preparations from Klebsiella microbes and antibodies to collagen types I, III, IV, and V were detected in patients with CD and patients with ankylosing spondylitis (AS). Molecular similarities were found between Klebsiella nitrogenase and HLA-B27 genetic markers and between Klebsiella pullulanase and collagen fibers types I, III, and IV. Furthermore, significantly positive correlations and cross-reactivity binding activities were observed between anti-Klebsiella and anticollagen antibodies among patients with CD and AS. Early treatment of CD patients with anti-Klebsiella measures is proposed, which may involve the use of antibiotics and low starch diet together with other traditionally used immunomodulatory, immunosuppressive, or biologic agents.

PMID: 16941202 [PubMed - indexed for MEDLINE]

 

[Nicola38]

Can anyone explain this in laymans terms!!??

 

[farm]

Ankylosing spondylitis is a form of chronic inflammation of the spine and the sacroiliac joints. The sacroiliac joints are located in the low back where the sacrum (the bone directly above the tailbone) meets the iliac bones (bones on either side of the upper buttocks). Chronic inflammation in these areas causes pain and stiffness in and around the spine. Over time, chronic spinal inflammation (spondylitis) can lead to a complete cementing together (fusion) of the vertebrae, a process referred to as ankylosis. Ankylosis leads to loss of mobility of the spine.

Seems he's saying there is a link between that and Crohns.

 

[Mazen]

The interesting thing is that it points to bacteria as partly responsible for these auto-immune diseases and recommends a low starch diet...

 

[D Bergy]

I would add that in the absence of these bacteria, the disease does not exist, only the potential to get it. In my opinion, based on my treatment results.

Dan

 

[fenway1971]

Interesting new research that again seems to suggest a bacterial link.

On an aside, when I first read this, I read klebsiella as kielbasa and thought...oh man, all that polish food as a child killed me! LOL.

 

[misscris]

hahaha Fen, I read it the same way the first time too. haha

 

[D Bergy]

I hope that puts an end to "the body attacking itself" hypothesis.

That never made much sense to me, and it seemed the remotest of all explanations.

Dan

 

[GoJohnnyGo]

Thank you for that link, Mazen.

I suffer from both. Funny how your body tells you things -- I've been gradually reducing starch in my diet if for no other reason than I felt marginally better.

 

[Mazen]

Here is followup on the above study, about a doctor treating AS patients with a low starch diet very similar to SCD.

http://www.kickas.org/medical/15.shtml


Summary The majority of ankylosing spondylitis (AS) patients not only possess HLA-B27, but during active phases of the disease have elevated levels of total serum IgA, suggesting that a microbe from the bowel flora is acting across the gut mucosa.
Biochemical studies have revealed that Klebsiella bacteria, not only possess 2 molecules carrying sequences resembling HLA-B27 but increased quantities of such microbes are found in fecal samples obtained from AS patients and such patients have Crohn's like lesions in the ileo-caecal regions of the gut. Furthermore AS patients from 10 different countries have been found to have elevated levels of specific antibodies against Klebsiella bacteria. It has been suggested that these Klebsiella microbes, found in the bowel flora, might be the trigger factors in this disease and therefore reduction in the size of the bowel flora could be of benefit in the treatment of AS patients.
Microbes from the bowel flora depend on dietary starch for their growth and therefore a reduction in starch intake might be beneficial in AS patients. A "low starch diet" involving a reduced intake of "bread, potatoes, cakes and pasta" has been devised and tested in healthy control subjects and AS patients. The "low starch diet" leads to a reduction of total serum IgA in both healthy controls as well as patients, and furthermore to a decrease in inflammation and symptoms in the AS patients.The role of a "low starch diet" in the management of AS requires further evaluation.

 

[bjeffrey]

Thank you fo rthe link Mazen!

 

[bella_sky]

OMG!! My GI just told me to today I need tested for this!! Thanks for the info!!!!

 

[RedSoxFan]

I concur. I began having back pain about 5 years before I got hit with CD. I continue to have lower back pain but can control it with exercise. I’ve been on and off my low carb diet for several years. I feel significantly better when I maintain a strict low carb diet. The more I stray the worse I feel. Just a personal observation, but it makes sense to me.

 

[CrohnieCarolyn]

Hmmmm interesting indeed! I have suffered back pain too for years and even before the Crohns started - maybe we should do a survey and see how many of us have back issues - just for interest...

 

[my4mack]

Just found out one of my 5 sisters has the HLA-B27 marker gene and ankylosing spondylitis (AS) and another sister also has the HLA-B27 gene and had an eye condition caused by it about 20 years ago. Perhaps there is a link to autoimmune diseases on both sides of the family for my children? My husband, his mother, and 3 of our children have Crohn's. I also have numerous relatives on my mom's side of the family with fibromyalgia, MS, and several other Autoimmune diseases. Many on both sides of my family, including some of our children suffer from asthma and allergies. Could they be related somehow?

 

[tek254]

I have both of these wonderful conditions and according to my rheumy, the as was first (some 20 years ago but dx 3 years ago).