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International Journal of Rheumatic... Apr 2022The aim of this study is to evaluate the association between Klebsiella pneumoniae infection and ankylosing spondylitis (AS). (Meta-Analysis)
Meta-Analysis
AIM
The aim of this study is to evaluate the association between Klebsiella pneumoniae infection and ankylosing spondylitis (AS).
METHOD
Five electronic databases, PubMed, Embase, Medline, Web of Science, and Scopes, were searched until September 29, 2021. Cohort and case-control studies that assessed the association between K. pneumoniae infection and AS were included. Pooled odds ratio (OR) was selected to show the effect size. Subgroup analysis (active or inactive AS) and 2 forms of sensitivity analysis were conducted. All statistical analyses were conducted by using STATA 12.0.
RESULTS
There were 25 case-control studies finally included, including 8 studies concerning presence of K. pneumoniae in feces, and 17 studies concerning serum antibody (immunoglobulin [Ig]G, IgM, IgA) against K. pneumoniae. The results suggested that when compared with healthy people, presence of K. pneumoniae in feces was associated with AS (OR: 5.65; 95% CI: 1.68-19.00). Similarly, when compared with healthy people, higher positive rates of IgA (OR: 6.28; 95% CI: 3.32-11.91) and IgG (OR: 5.22; 95% CI: 1.36-19.99) were observed. Subgroup analyses suggested that association between K. pneumoniae and AS appears stronger in active AS.
CONCLUSION
When compared with healthy people, a significantly higher positive rate of K. pneumoniae in feces, serum IgA and IgG were observed in patients with AS, suggesting that K. pneumoniae probably plays a crucial role in the occurrence of AS. The findings in this study need further prospective investigations for confirmation.
Topics: Antibodies, Bacterial; Humans; Immunoglobulin A; Immunoglobulin G; Klebsiella pneumoniae; Spondylitis, Ankylosing
PubMed: 35019225
DOI: 10.1111/1756-185X.14283 -
Microbial Pathogenesis Jul 2019The pathogenesis and development of ankylosing spondylitis (AS) is concealed and complicated. In recent years, alterations in gut microbiota of AS patients have been... (Review)
Review
The pathogenesis and development of ankylosing spondylitis (AS) is concealed and complicated. In recent years, alterations in gut microbiota of AS patients have been largely investigated, although the underlying mechanisms remain unclear. This article reviews the recent studies on changes of gut microbiota in AS patients, and discusses the possible correlation between intestinal dysbiosis and AS development from aspects including genetic factor HLA-B27, mucosal immune responses and the depression accompanying AS.
Topics: Cytokines; Dysbiosis; Gastrointestinal Microbiome; HLA-B27 Antigen; Humans; Immunity, Mucosal; Immunoglobulin A; Inflammation; Intestines; Spondylitis, Ankylosing
PubMed: 31039390
DOI: 10.1016/j.micpath.2019.04.038 -
Current Rheumatology Reports Jul 2023This study aims to review recent studies on risk factors for syndesmophyte growth in ankylosing spondylitis (AS) and on treatment effects. (Review)
Review
PURPOSE OF REVIEW
This study aims to review recent studies on risk factors for syndesmophyte growth in ankylosing spondylitis (AS) and on treatment effects.
RECENT FINDINGS
New genetic studies, including a genome-wide association study, provided only limited evidence of specific genetic associations with radiographic severity. Measures of inflammation, including vertebral osteitis and C-reactive protein level, were strongly associated with radiographic progression, while studies of adipokines had mixed results. Mesenchymal stem cells from HLA-B27 positive AS patients were found to promote vertebral ossification via a pathway of B27 misfolding, retinoic acid receptor-β activation, and increased bone alkaline phosphatase. Low vertebral trabecular bone density is associated with syndesmophyte growth, with reciprocal effects when bridged. Several observational studies suggested radiographic severity was reduced by treatment with tumor necrosis factor inhibitors, particularly when longer than 2 years. Syndesmophyte development in AS is the result of a complex, incompletely understood, interplay of inflammatory and mechanical factors.
Topics: Humans; Spondylitis, Ankylosing; Genome-Wide Association Study; Spine; Inflammation; Osteogenesis; Musculoskeletal Diseases
PubMed: 37126093
DOI: 10.1007/s11926-023-01104-x -
Emergency Radiology Jun 2021The purpose of this study is to examine the incidence, location, and magnetic resonance imaging (MRI) features of spinal epidural hematoma (SEH) and spinal subdural...
PURPOSE
The purpose of this study is to examine the incidence, location, and magnetic resonance imaging (MRI) features of spinal epidural hematoma (SEH) and spinal subdural hematoma (SSH) in post-traumatic ankylosing spondylitis (AS) patients.
METHODS
A total of 2256 consecutive referrals for urgent and emergency MRI scans of the spine over a period of eight years and nine months were manually reviewed for any mentions indicating axial ankylosis and post-traumatic spinal hematoma. We found 164 patients with ankylosed spines complicated by spinal fracture, of whom 32 had AS. Of the 132 excluded patients, 80 had diffuse idiopathic skeletal hyperostosis (DISH). The primary outcome was the presence of spinal hematoma, and the secondary outcome was spinal canal narrowing and spinal cord impingement. Two musculoskeletal radiologists and one fellow in musculoskeletal radiology reviewed the images for the presence of spinal hematoma and related signal characteristics, blinded to one another and initial reports.
RESULTS
Of 28 post-traumatic AS patients, 19 had SEHs and five had spinal SSHs. There was a statistically significant difference between Frankel grades before and after surgery in respect of neurological improvement (p = 0.008). Patients who had radiologically proven spinal cord impingement showed more severe neurological deficits (p = 0.012). Hematomas with T1 heterogeneity showed a significantly increased delay (p = 0.047) between injury and imaging, while other signal characteristics were only approximate.
CONCLUSIONS
Both SEH and SSH are common complications in post-traumatic AS patients. Patients benefit from surgery, but the relevance of spinal hematoma as a separate factor causing neurological deficit remains unclear.
Topics: Hematoma, Epidural, Spinal; Humans; Hyperostosis, Diffuse Idiopathic Skeletal; Magnetic Resonance Imaging; Spinal Fractures; Spondylitis, Ankylosing
PubMed: 33452963
DOI: 10.1007/s10140-020-01881-3 -
Clinical and Experimental Rheumatology May 2022Rheumatologic diseases may impair the quality of life (QoL) by affecting sexual functions in different ways. We aimed to evaluate sexual functions and the...
OBJECTIVES
Rheumatologic diseases may impair the quality of life (QoL) by affecting sexual functions in different ways. We aimed to evaluate sexual functions and the disease-related variables, physical and psychogenic states in female patients with ankylosing spondylitis and non-radiographic axial spondyloarthropathy.
METHODS
A total of 98 women with axial spondyloarthropathy (axSpA) and 99 healthy females were included in the study. The axSpA group was divided into two subgroups as ankylosing spondylitis (AS) and non-radiographic axial spondyloarthropathy (nr-axSpA) (62 AS and 36 nr-axSpA). The patients' disease-related variables recorded. All the women in the axSpA and control groups were evaluated gynaecologically. The female sexual function index (FSFI), Health Status Questionnaire [Short Form (SF)-36], and Hospital Depression and Anxiety Scale (HADS) were applied to all participants.
RESULTS
Clitoral and labial atrophy and speculum pain score were significantly higher in the axSpA group (p<0.05). The FSFI and QoL-SF-36 scores were significantly lower and the HAD-D and HAD-A scores were significantly higher of in the axSpA group than in the control group (p<0.05 for all). There was no significant between the axSpA subgroups in terms of the FSFI, QoL-SF-36 and HAD scores.
CONCLUSIONS
In elderly women with axSpA, disease duration and limitation of movement are more effective in genital atrophy and sexual functions, but there is no difference between those with AS and nr-axSpA in relation to sexual functions and psychological burden.
Topics: Aged; Atrophy; Female; Humans; Quality of Life; Spondylarthritis; Spondylarthropathies; Spondylitis, Ankylosing
PubMed: 34128800
DOI: 10.55563/clinexprheumatol/raqpga -
Endocrine, Metabolic & Immune Disorders... Feb 2018Familial Mediterranean Fever (FMF) is one of the most common hereditary auto-inflammatory diseases especially among Arabs, Armenians, Jews, and Turks characterized by... (Review)
Review
BACKGROUND
Familial Mediterranean Fever (FMF) is one of the most common hereditary auto-inflammatory diseases especially among Arabs, Armenians, Jews, and Turks characterized by recurrent attacks of fever, abdominal pain and arthritis.Whether the prevalence of ankylosing spondylitis (AS) is increased in FMF patients is a matter of debate. This review will summarize all the literature data relevant to this topic.
METHODS
We searched all the articles through PubMed and Embase databases from 1963 until 2017 addressing the relationship between AS and FMF patients.
RESULTS
The prevalence of AS among FMF patients is highly variable. However, a significant relationship was found to exist between MEFV gene mutations and AS. Most patients with coexistent MEFV gene mutations and AS were human leucocyte antigen B27 (HLA-B27) negative. The effect of these mutations on AS severity and prognosis was not significant.
CONCLUSION
Large based population studies are needed to further assess the existence of MEFV gene mutations among AS patients and their effect on the clinical course of the disease in addition to assessment of AS prevalence in patients with FMF.
Topics: Diagnosis, Differential; Disease Progression; Familial Mediterranean Fever; Genetic Predisposition to Disease; HLA-B27 Antigen; Humans; Mutation; Prevalence; Spondylitis, Ankylosing
PubMed: 28982344
DOI: 10.2174/1871530317666171003155517 -
Nature Reviews. Rheumatology Jun 2017Over the past 5 years, advances in high-throughput techniques and studies involving large cohorts of patients have led to considerable advances in the identification of... (Review)
Review
Over the past 5 years, advances in high-throughput techniques and studies involving large cohorts of patients have led to considerable advances in the identification of novel genetic associations and immune pathways involved in ankylosing spondylitis (AS). These discoveries include genes encoding cytokine receptors, transcription factors, signalling molecules and transport proteins. Although progress has been made in understanding the functions and potential pathogenic roles of some of these molecules, much work remains to be done to comprehend their complex interactions and therapeutic potential in AS. In this Review, we outline the current knowledge of AS pathogenesis, including genetic risk associations, HLA-B27-mediated pathology, perturbations in antigen-presentation pathways and the contribution of the type 3 immune response.
Topics: Antigen Presentation; Humans; Interleukin-17; Spondylitis, Ankylosing
PubMed: 28446810
DOI: 10.1038/nrrheum.2017.56 -
Expert Review of Pharmacoeconomics &... Apr 2015The aim of this systematic review was to collect and summarize all current data on the indirect costs related to absenteeism and presenteeism associated with ankylosing... (Meta-Analysis)
Meta-Analysis Review
The aim of this systematic review was to collect and summarize all current data on the indirect costs related to absenteeism and presenteeism associated with ankylosing spondylitis. The search was conducted using Medline, Embase and Centre for Reviews and Dissemination databases. All collected costs were recalculated to average annual cost per patient, expressed in 2013 prices USD using the consumer price index and purchasing power parity. Identified studies were then analyzed to assess their possible inclusion in the meta-analysis. We identified 32 records. The average annual indirect cost per patient varies among all the identified results from US$660.95 to 45,953.87. The mean annual indirect per patient equals US$6454.76. This systematic review summarizes current data related to indirect costs generated by ankylosing spondylitis; it revealed the great economic burden of the disease for society. We observed a great variety of the considered components of indirect costs and their definitions.
Topics: Absenteeism; Cost of Illness; Humans; Spondylitis, Ankylosing; Workplace
PubMed: 25579502
DOI: 10.1586/14737167.2015.1001370 -
Journal of Nepal Health Research Council Apr 2021There is a close correlation between ankylosing spondylitis and uveitis, other less common ocular manifestations being episcleritis and scleritis. Though the prognosis...
BACKGROUND
There is a close correlation between ankylosing spondylitis and uveitis, other less common ocular manifestations being episcleritis and scleritis. Though the prognosis of uveitis is good, prompt treatment is required to prevent long-term complications. This study aimed to estimate the prevalence of uveitis in patients with ankylosing spondylitis who follow outpatient clinic of a tertiary care hospital.
METHODS
A descriptive cross-sectional study was done in medicine outpatient department of a tertiary care hospital for 6 months. Ethical clearance was obtained from the institutional review board of National Academy of Medical Sciences. Convenient sampling was done. The data collected were entered in Microsoft excel to tabulate the data and analyze the results.
RESULTS
Out of 81 participants, 26 patients had a history of uveitis (32%). Most of the patients in this study were of 18-30 years. Uveitis was most common in patients with both axial and peripheral disease (41%) compared to those with just peripheral disease (32%). Uveitis was more common among males (32.2%) than females (31.5%).
CONCLUSION
In patients with spondyloarthritis uveitis was present in 32% of the patient with more common in patient with both axial and peripheral arthritis. Timely diagnosis of uveitis in ankylosing spondylitis can prevent the sequelae with prompt treatment.
Topics: Cross-Sectional Studies; Female; Humans; Male; Nepal; Spondylarthritis; Spondylitis, Ankylosing; Uveitis
PubMed: 33934141
DOI: 10.33314/jnhrc.v19i1.3365 -
Rheumatology International Dec 2017Ankylosing spondylitis (AS) is a chronic and inflammatory rheumatic disease, characterized by pain and structural and functional impairments, such as reduced mobility... (Review)
Review
Ankylosing spondylitis (AS) is a chronic and inflammatory rheumatic disease, characterized by pain and structural and functional impairments, such as reduced mobility and axial deformity, which lead to diminished quality of life. Its treatment includes not only drugs, but also nonpharmacological therapy. Exercise appears to be a promising modality. The aim of this study is to review the current evidence and evaluate the role of exercise either on land or in water for the management of patients with AS in the biological era. Systematic review of the literature published until November 2016 in Medline, Embase, Cochrane Library, Web of Science and Scopus databases. Thirty-five studies were included for further analysis (30 concerning land exercise and 5 concerning water exercise; combined or not with biological drugs), comprising a total of 2515 patients. Most studies showed a positive effect of exercise on Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, pain, mobility, function and quality of life. The benefit was statistically significant in randomized controlled trials. Results support a multimodal approach, including educational sessions and maintaining home-based program. This study highlights the important role of exercise in management of AS, therefore it should be encouraged and individually prescribed. More studies with good methodological quality are needed to strengthen the results and to define the specific characteristics of exercise programs that determine better results.
Topics: Clinical Trials as Topic; Exercise; Exercise Therapy; Female; Humans; Male; Pain Management; Quality of Life; Randomized Controlled Trials as Topic; Spondylitis, Ankylosing; Treatment Outcome
PubMed: 28983663
DOI: 10.1007/s00296-017-3829-8