Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P01889 (ankylosing spondylitis)
 5,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sera from 156 patients with ulcerative colitis and Crohn's disease were tested for the presence of immune complexes, by the detection of anti-complementary activity and 125I-labelled Clq precipitation. Using aggregated IgG, a comparison between the two tests indicated that the anti-complementary test was most sensitive to aggregates of 11S in size, while the 125I-labelled Clq test detected aggregates over 20S in size. Excess anti-complementary activity was common in patients with active bowel disease, and in those with extra-intestinal manifestations, particularly acute arthritis, ankylosing spondylitis and liver disease. Large complexes were only common in patients with liver disease. Immune complexes in the gut mucosa may play a role in the pathogenesis of these diseases, and the deposition of circulatory immune complexes may explain at least some of the extra-intestinal manifestations.
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PMID:Immune complexes in ulcerative colitis and Crohn's disease. 90 71

Whole gut lavage fluid is a useful source of material for the study of intestinal immunity and inflammation in humans. Systemic and mucosal antibodies to Klebsiella pneumoniae were measured by enzyme linked immunosorbent assay (ELISA) in serum samples and whole gut lavage fluid from 14 patients with ankylosing spondylitis, 14 with Crohn's disease, and 16 immunologically normal controls. As the concentration of IgG in whole gut lavage fluid reflects disease activity in Crohn's disease, this approach was used to detect intestinal inflammation in patients with ankylosing spondylitis who also had disease activity and use of non-steroidal anti-inflammatory drugs (NSAIDs) recorded. Small intestinal permeability to cellobiose and mannitol was also studied. In serum samples, levels of IgA antibody to klebsiella were high in patients with Crohn's disease and in patients with active ankylosing spondylitis, and were significantly correlated with the erythrocyte sedimentation rate in patients with ankylosing spondylitis. Levels of IgG antibody to klebsiella were also high in patients with Crohn's disease. Studies of whole gut lavage fluid showed similar levels of IgA antibody to klebsiella in the three study groups, but levels of whole gut lavage fluid IgM and IgG antibodies to klebsiella were high in patients with Crohn's disease. Levels of IgG in whole gut lavage fluid were high in patients with Crohn's disease but in only one patient with ankylosing spondylitis, though the cellobiose/mannitol permeability ratio was abnormal in eight of 13 patients with ankylosing spondylitis. It is concluded that high levels of serum IgA antibody to klebsiella are not specific to ankylosing spondylitis, and that there is no evidence of an abnormal intestinal IgA antibody response to klebsiella in patients with ankylosing spondylitis.
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PMID:Systemic and mucosal antibodies to Klebsiella in patients with ankylosing spondylitis and Crohn's disease. 148 10

There is a link between gut and spondyloarthropathies, which extends from the acute ReA triggered by enteritis due to gram-negative bacteria to ankylosing spondylitis and peripheral arthritis in association with Crohn's disease and ulcerative colitis. In addition, in studies using ileocolonoscopy, an unexpectedly high proportion of patients with prolonged or chronic seronegative oligoarthritis or sacroiliitis have inflammatory changes in the terminal ileum or colon or both. These changes have either features of acute gut inflammation or infection, but about one quarter of the patients have chronic lesions, probably early Crohn's disease. The conventional treatment of spondyloarthropathies consists of liberal use of NSAIDs, local corticosteroid injections if indicated, and physiotherapy. In patients with acute ReA, the conventional antimicrobial therapy to eradicate the triggering infection is necessary if there is evidence of chlamydial or gonococcal etiology. This therapy does not, however, influence the course of the subsequent arthritis. Patients with chlamydia arthritis probably host living bacteria for prolonged periods, and they seem to benefit from a prolonged antimicrobial therapy with tetracyclines. In the face of frequent gut involvement in patients with prolonged or chronic spondyloarthropathies, the use of sulfasalazine is the logical alternative, as short-term studies on patients with ankylosing spondylitis indicate.
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PMID:Gut and spondyloarthropathies. 156 4

Ileocolonoscopy was performed on 354 patients with spondyloarthropathies. Histologically, the population could be divided into 145 patients with normal gut histology, 88 patients with acute inflammatory lesions and 121 patients with chronic inflammatory lesions. A number of clinical, biologic, radiologic and genetic variables were determined before ileocolonoscopy. Chronic gut lesions were associated with a family history of ankylosing spondylitis (AS) and Crohn's disease, several episodes of diarrhea, an increased stool frequency, elevated inflammatory serum variables, reduced axial mobility, the presence of sacroiliitis, bamboo spine, destructive joint lesions, a diagnosis of AS and HLA-Bw62 positivity. As the frequency of HLA-Bw62 is also increased in proven Crohn's disease, this would suggest that chronic gut lesions are related to this disease. Acute inflammatory lesions were related to a higher fecal carriage of specific bacteria and to the diagnosis of undifferentiated spondyloarthropathy, especially the enterogenic forms of reactive arthritis. Consequently, these lesions also appear to be related to a bacterially induced gut inflammation. Gut histology was normal in urogenital inflammation and urogenital reactive arthritis, suggesting a different portal of entry for antigens. The 3 histologic pictures of the gut (normal, acute and chronic) inflammation seem to correlate with different clinical, biologic and radiologic manifestations of the disease concept of spondyloarthropathies.
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PMID:Gut inflammation in the spondyloarthropathies: clinical, radiologic, biologic and genetic features in relation to the type of histology. A prospective study. 176 80

In the seronegative spondyloarthropathies the hip lesions can be subdivided into a concentric type progressing to ankylosis and an eccentric type leading to joint destruction. Radiologic examination of the hips was performed in 177 of 211 patients suffering from seronegative spondyloarthropathies on whom ileocolonoscopy with biopsies of ileum and colon was performed; in 27 of these 177 patients, hip lesions were demonstrated. The concentric form seems to be radiologically, clinically and genetically more related to axial involvement; moreover, the frequency of subclinical gut inflammation was the same as in the group of patients with ankylosing spondylitis (AS) without peripheral arthritis, and thus significantly lower than in patients with AS with peripheral arthritis. Eccentric, destructive hip lesions seem to be unrelated to axial involvement, but they are associated with the presence of HLA-Bw62 and gut inflammation (100%), mainly of the chronic, Crohn disease-like type.
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PMID:Destructive hip lesions in seronegative spondyloarthropathies: relation to gut inflammation. 233 55

Whipple's disease is a curious disorder with the involvement of many organ systems, primarily gut, synovium and the central nervous system, characterized by the presence of numerous proliferating bacteria in tissue macrophages and other cell types. While clinically this disease entity has previously been defined by the classical triad of diarrhoea, malabsorption and weight loss, some patients do not show these features. In this report, a clinically unusual case of Whipple's disease is described presenting with high persistent fever, severe arthralgias and headaches, but without malabsorption, diarrhoea or weight loss. Nevertheless, the histological and electron microscopical pictures demonstrated the typical findings of intracellular micro-organisms along with the presence of bacteria in Schwann nerve cells, which has only once been described previously. Immunological findings before treatment demonstrated a decrease of T cells with the helper/inducer phenotype, and a concomitant rise in cells with the suppressor/cytotoxic phenotype, an elevation of "activated" Ia positive T cells and a significant reduction of T cell mitogenic responsiveness. Of special interest, after a successful treatment these immunological abnormalities shifted to normal with the exception of a still elevated number of Ia+ T cells. The discussion of this unusual case of Whipple's disease includes - besides possible cellular immunological abnormalities - genetic factors, especially since this patient was HLA-B-27-positive as was his son who is suffering from ankylosing spondylitis.
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PMID:[Immunologic and electron microscopic findings in an unusual case of Whipple's disease]. 258 Jan 16

In order to evaluate the frequency of subclinical gut involvement in the seronegative spondylarthropathies, ileocolonoscopy with biopsies of the colon, ileocecal valve and ileum were performed on 211 patients with ankylosing spondylitis (AS), reactive arthritis (ReA) and undifferentiated spondylarthropathies. Inflammatory gut lesions were detected in a large number of these patients. It was concluded that the group of undifferentiated spondylarthropathies could be split into fairly equal subgroups: one subgroup suffering from subclinical inflammatory bowel disease associated with peripheral joint symptoms, a second subgroup presenting a form of enterogenic ReA, and a third subgroup in which no relation with the gut could be demonstrated. Ankylosing spondylitis, which has to be considered as a form of undifferentiated seronegative spondylarthropathy, could be subdivided into the same subgroups. These findings confirm the existence of subclinical gut involvement in patients with seronegative spondylarthropathies.
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PMID:Subclinical involvement of the gut in undifferentiated spondylarthropathies. 259 Nov 24

A prospective endoscopic and histologic study of terminal ileum and colorectum in 211 patients with seronegative spondylarthropathy revealed macroscopic inflammatory lesions varying from erythema to superficial erosions in 30% of the patients and microscopic inflammation in 61%. Two types of inflammation were observed: an acute inflammation resembling an infectious enterocolitis and a chronic inflammation. In idiopathic reactive arthritis both types of inflammation were equally present, whereas chronic inflammation predominated in patients with ankylosing spondylitis. In 32% of patients with chronic inflammation, the lesions particularly resembled early Crohn's disease. Repeat ileocolonscopy on 19 patients demonstrated a parallel evolution of joint symptoms and histologic lesions. All patients with acute inflammation went into clinical and histologic remission, whereas lesions persisted in patients with Crohn-like inflammation. In patients with chronic inflammation, remission and persistence were observed equally. This study identified a group of patients with seronegative spondylarthropathy which, even in the absence of gastrointestinal symptoms, showed evidence of gut inflammation, probably inducing an increased gut permeability with transgression of the oral tolerance and absorption of provocative antigens into the circulation. It is also possible that both diseases reflect a common underlying process.
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PMID:Ileocolonoscopy in seronegative spondylarthropathy. 231 69

Ileocolonoscopy on patients with HLA-B27 related disease, reactive arthritis and ankylosing spondylitis (AS) with peripheral arthritis, revealed the presence of inflammatory lesions in biopsy specimens from the ileum in 71 and 60% of the cases, respectively. A 2nd ileocolonoscopy was performed on 14 patients, 4 to 22 months after the first. In 6 of the 7 patients in articular clinical remission, the inflammatory gut lesions had disappeared. The gut biopsies of the 7 patients with active joint disease continued to show inflammatory lesions. One of these patients underwent a 3rd ileocolonoscopy after having gone into clinical remission, possibly secondary to treatment with sulfasalazine; the histology was completely normal. The strong relationship between clinical articular inflammation and gut inflammation seems to support the hypothesis that in B27 related diseases, repetitive exogenous triggering causing transgression of oral tolerance by increased gut permeability, provokes and maintains the joint inflammation.
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PMID:Repeat ileocolonoscopy in reactive arthritis. 288 54

Ileocolonoscopy with biopsy of caecum, ileocaecal valve and terminal ileum were performed on 232 patients with seronegative spondylarthropathies and on 65 control patients. Inflammatory gut lesions were found in 65% of the patients with reactive arthritis (ReA) and in 57% of the patients with ankylosing spondylitis (AS), especially in those with peripheral arthritis. The controls had a normal gut. This finding would suggest that exogenous factors causing inflammation of the gut lead to a disturbed permeability of the gut wall or to a deficient local immunological defence mechanism permitting antigens to enter the circulation, inducing the joint and tendon inflammation. 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. Patients presenting some of the histological lesions found on biopsy (especially active chronic lesions) and patients with proven Crohn's disease were found to share a genetic marker (HLA-BW62). This would suggest that 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.
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PMID:Ileocolonoscopic findings in seronegative spondylarthropathies. 304 80


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