Review Article
The Link between Ankylosing Spondylitis, Crohn’s Disease, Klebsiella, and Starch Consumption
Table 1
Possible explanations for some of the predominantly associated features in “AS.”
| “AS” associated features | Suggested explanation |
| Fluctuation in the course of the disease and low concordance rates in identical twins | Involvement of nongenetic, environmental, factors in the disease pathogenesis |
| High association with HLA-B27
| Cross-reactivity of these antigens with Klebsiella |
| Predilection for involvement of the sacroiliac and vertebral joints
| Lymphatic drainage plexus of the bowel (containing Klebsiella antibodies) is in close proximity to the sacro-iliac joints |
| Polyarticular joint involvement
| Cross-reactivity between collagen I, III, and IV fibres and Klebsiella |
| Associated uveitis
| Cross-reactivity of uveal tract tissues with Klebsiella |
| Associated enthesitis
| A site of inflammation in the early cases of AS |
| Increased total IgA and secretory IgA in sera of AS patients | Enhanced mucosal immune response due to subclinical bowel infections by Klebsiella |
| Higher onset of AS among young people | Increased intake of starch diet among young age groups |
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