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| ==Overview== | | ==Overview== |
| Ankylosing spondylitis is a systemic [[rheumatic]] disease, and it is one of the [[seronegative spondyloarthropathies]]. About 90% of the patients express the [[HLA-B27]] genotype. [[Tumor necrosis factor-alpha]] (TNF α) and [[IL-1]] are also implicated in ankylosing spondylitis. Although specific [[autoantibodies]] cannot be detected, it's response to immunosuppresive medication has prompted it's classification as an [[autoimmune disease]].
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| ==Pathophysiology== | | ==Pathophysiology== |
| Hypotheses on its pathogenesis include a cross-reaction with antigens of the [[Klebsiella]] bacterial strain (Tiwana et al. 2001).<ref> {{cite journal | author = Tiwana H, Natt R, Benitez-Brito R, Shah S, Wilson C, Bridger S, Harbord M, Sarner M, Ebringer A | title = Correlation between the immune responses to collagens type I, III, IV and V and Klebsiella pneumoniae in patients with Crohn's disease and ankylosing spondylitis. | journal = Rheumatology (Oxford) | volume = 40 | issue = 1 | pages = 15-23 | year = 2001 | id = PMID 11157137}}</ref>
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| Particular authorities argue that elimination of the prime nutrients of Klebsiella (starches) would decrease antigenemia and improve the musculoskeletal symptoms. On the other hand, Khan (2002) argues that the evidence for a correlation between Klebsiella and AS is circumstantial so far, and that the efficacy of low-starch diets has not yet been scientifically evaluated.<ref>{{cite book | author=Khan MA. | year=2002 | title=Ankylosing spondylitis: The facts | publisher= Oxford University Press | id=ISBN 0-19-263282-5}}</ref>
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| Similarly, Toivanen (1999) found no support for the role of klebsiella in the etiology of primary AS.<ref>{{cite journal | author = Toivanen P, Hansen D, Mestre F, Lehtonen L, Vaahtovuo J, Vehma M, Möttönen T, Saario R, Luukkainen R, Nissilä M | title = Somatic serogroups, capsular types, and species of fecal Klebsiella in patients with ankylosing spondylitis. | journal = J Clin Microbiol | volume = 37 | issue = 9 | pages = 2808-12 | year = 1999 | id = PMID 10449457 | url=http://jcm.asm.org/cgi/content/full/37/9/2808?view=long&pmid=10449457}}</ref>
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| ===Associated Conditions===
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| *[[Ulcerative colitis]], | |
| *[[Crohn's disease]],
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| *[[Psoriasis]], and
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| *[[Reiter's disease]].
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| ==References== | | ==References== |