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Clinical and Developmental Immunology
Volume 2013 (2013), Article ID 872632, 9 pages
http://dx.doi.org/10.1155/2013/872632
Review Article

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

1Analytical Sciences Group, Kings College, 150 Stamford Street, London SE1 9NH, UK
2Department of Pathology and Microbiology, Kings Edward VII Memorial Hospital, 7 Point Finger Road, Paget DV04, Bermuda

Received 22 October 2012; Accepted 23 April 2013

Academic Editor: Chung Tei Chou

Copyright © 2013 Taha Rashid et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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.