Nissilä M, Lahesmaa R, Leirisalo-Repo M, Lehtinen K, Toivanen P, Granfors K
Rheumatism Foundation Hospital, Heinola, Finland.
J Rheumatol. 1994 Nov;21(11):2082-7.
To make a longitudinal study of antibodies to Klebsiella pneumoniae in patients with ankylosing spondylitis (AS) and to assess treatment effects. As a comparison we measured antibodies of 2 other gut associated bacteria, Escherichia coli and Proteus mirabilis.
In a double blind study in 84 Finnish outpatients with AS before and after 26 weeks' treatment with sulfasalazine or placebo we measured serum antibodies to Klebsiella pneumoniae, E. coli and Proteus mirabilis with ELISA: Serum samples of 100 healthy blood donors served as controls.
The levels of IgA class antibodies to all 3 bacteria were statistically significantly higher in the sera of the patients compared to the controls. During sulfasalazine treatment significant decreases were observed in concentrations of the IgA class antibodies to Klebsiella and E. coli whereas only a slight decrease was observed in the concentrations of IgA antibodies to Proteus mirabilis. There were no correlations between the clinical and laboratory results observed with sulfasalazine and decrease in concentrations of IgA class antibodies.
Our results agree with the role of gut associated lymphoid tissue in the pathogenesis of AS, but do not totally exclude Klebsiella pneumoniae as a specific agent contributing to the development of AS.
对强直性脊柱炎（AS）患者的肺炎克雷伯菌抗体进行纵向研究，并评估治疗效果。作为对照，我们检测了另外两种肠道相关细菌——大肠杆菌和奇异变形杆菌的抗体。
在一项双盲研究中，对84名芬兰AS门诊患者在接受柳氮磺胺吡啶或安慰剂治疗26周前后，采用酶联免疫吸附测定法（ELISA）检测其血清中肺炎克雷伯菌、大肠杆菌和奇异变形杆菌的抗体：100名健康献血者的血清样本作为对照。
与对照组相比，患者血清中针对所有3种细菌的IgA类抗体水平在统计学上显著更高。在柳氮磺胺吡啶治疗期间，观察到针对肺炎克雷伯菌和大肠杆菌的IgA类抗体浓度显著下降，而针对奇异变形杆菌的IgA抗体浓度仅略有下降。柳氮磺胺吡啶治疗的临床和实验室结果与IgA类抗体浓度下降之间没有相关性。
我们的结果支持肠道相关淋巴组织在AS发病机制中的作用，但并不完全排除肺炎克雷伯菌作为促成AS发病的特定病原体。
