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A possible link between Crohn’s disease and ankylosing spondylitis via Klebsiella infections

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Abstract

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.

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Acknowledgements

We thank the Trustees of the Middlesex Hospital, the Arthritis Research Campaign (Grant EO514), and “American Friends of King’s College London” for their support.

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Authors and Affiliations

  1. School of Biomedical and Health Sciences, King’s College London, 150 Stamford Street, London, SE1 9NN, UK

    Alan Ebringer, Taha Rashid & Harmale Tiwana

  2. Department of Rheumatology, Middlesex Hospital, UCL School of Medicine, London, UK

    Alan Ebringer

  3. Department of Pathology, King Edward VII Memorial Hospital, Hamilton, Bermuda

    Clyde Wilson

  4. Department of Microbiology, King Edward VII Memorial Hospital, Hamilton, Bermuda

    Clyde Wilson

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  1. Alan Ebringer
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Correspondence to Alan Ebringer.

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Ebringer, A., Rashid, T., Tiwana, H. et al. A possible link between Crohn’s disease and ankylosing spondylitis via Klebsiella infections. Clin Rheumatol 26, 289–297 (2007). https://doi.org/10.1007/s10067-006-0391-2

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