Ankylosing Spondylitis Causes
Ankylosing spondylitis is a neck pain condition that has a strong genetic component with approximately 90% of patients testing positive for the HLA-B27 gentoype in a review by Reveille (2006). However, the same review found that only 5% of those with the HLA-B27 genotype actually contract the disease, meaning that other factors are at play in the pathology of ankylosing spondylitis and it is not inevitable for those with this genotype.
As yet, specific autoantibodies have not been found for ankylosing spondylitis but there is a seeming consensus that tumor necrosis factor alpha (TNFα) and Inter Leukin-1 (IL-1) are involved in the pathology of the condition. Research is ongoing into the involvement of CD8 T cells and CD4 T cells and their interaction with the HLA-B27 genotype as there appears to be unusual activity for these types of cells.
There is some speculation, as yet with no firm evidence, that the Klebsiella bacterial strain may trigger an autoimmune response by cross-reaction of the body’s HLA-B27 gene and the bacterial antigen. This has implications for the treatment of ankylosing spondylitis as certain types of diet may restrict the disease’s impact if this is found to be a primary mechanism of disease progression. A history of gastrointestinal infections may be noted in the case histories of those who go on to develop ankylosing spondylitis. This may precipitate a breakdown in barrier function of the intestine, allowing pathogens to cross the membrane and trigger an autoimmune response localized to the hip area. As yet there is only circumstantial evidence to support this theory, although keeping the gastrointestinal system healthy is beneficial for many reasons including proper absorption of nutrients which can help fight inflammation and keep joints healthy in general.
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