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#516926 - 04/19/17 07:11 AM Recent advances in understanding spondyloarthritis
DavidP Offline
Master_Sergeant_AS_Kicker

Registered: 09/24/07
Posts: 604
Loc: Sale, Victoria, Australia
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5365215/

This is another good overview of recent advances.

Particularly interesting is stuff on unusual entheseal-resident T cell population that are responsive to the gut derived (inflammatory gut)cytokine IL23 - hence inflammation in the gut is the driver of clinical manifestations in the SpA's.

Regards again David
_________________________
Dx Oct 2006 B27+ undifferentiated spondlyarthropathy (uSpA) with mild sebhorrhoeic dermatitis and mild Inflammatory Bowel Disease (IBD) controlled by NSD since 2007.

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#517036 - 05/01/17 11:12 AM Re: Recent advances in understanding spondyloarthritis [Re: DavidP]
Lon Offline
Very_Addicted_to_AS_Kickin

Registered: 09/11/01
Posts: 8360
Loc: Gillette, Wyoming
Thanks David!
_________________________
I keep the New Covenant,
when I fail....I am pulled
back into place by HIM.

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#517046 - 05/02/17 07:19 AM Re: Recent advances in understanding spondyloarthritis [Re: Lon]
DavidP Offline
Master_Sergeant_AS_Kicker

Registered: 09/24/07
Posts: 604
Loc: Sale, Victoria, Australia
It was a pleasure, Lon.
You know, I'm always uncertain whether these sorts of articles are of much interest. Because of the level of jargon, the meaning in these papers is not always obvious; so that you are left wondering - is this profound or just simply incomprehensible? Nevertheless, it's good to know that there is an army of researchers out there tackling AS and related conditions - perhaps they don't get enough credit, so I'll take this opportunity to give them a BIG thank-you.
_________________________
Dx Oct 2006 B27+ undifferentiated spondlyarthropathy (uSpA) with mild sebhorrhoeic dermatitis and mild Inflammatory Bowel Disease (IBD) controlled by NSD since 2007.

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#517074 - 05/09/17 05:08 AM Re: Recent advances in understanding spondyloarthritis [Re: DavidP]
Robin_H Offline
Apprentice_AS_Kicker

Registered: 09/13/15
Posts: 92
Loc: Hubei, China
Thanks for this article!! I will take it to the rheumatoid doctor because he's adamant that there is no association between AS and bacteria. He's very young and I don't know where he got his training. He works in a GIANT hospital in China where I live (pop 10,000,000). He does know the standard AS diagnostic protocols.

I've emphasized to my GI doctor that if we cleared up the gut dysfunction then the AS symptoms (and other ones) might go away. The GI doctor says I have IBS according to an enhanced CT scan. They did a very basic stool test and all was OK. I took it upon myself to get a much more comprehensive stool test and B. Hominis, Candida, Citrobacter Freundii, etc showed up. The GI doctor refused to treat me for them.

In fact, when AS was first suspected two years ago I had no antibodies that were screened for by one of two rheumatologists. When I told her the series of events that seemed to have triggered the AS symptoms -- infection from scuba accident then NSAID over use then GI infection then growth of AS symptoms -- she nodded her head and said "yes.. there are good bugs and there are bad bugs. I will send you to a doctor I think that can help you." Her demeanor and tone disturbed me.

The next time I came to the same hospital office (doctors of all type would meet me at a single office) the doctor turned out to be a psychiatrist!!

I hope that was good for a laugh!

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#517076 - 05/09/17 06:27 AM Re: Recent advances in understanding spondyloarthritis [Re: Robin_H]
Frederick Offline
First_Degree_AS_Kicker

Registered: 03/28/06
Posts: 161
Originally Posted By Robin_H
Thanks for this article!! I will take it to the rheumatoid doctor because he's adamant that there is no association between AS and bacteria. [/b]
[b]There is a long established theory that A.S. is started by a bowel infection and/or diarrhea.



I've emphasized to my GI doctor that if we cleared up the gut dysfunction then the AS symptoms (and other ones) might go away.Sorry but A.S. is much more difficult to treat than just to get rid of a gut dysfunction

I took it upon myself to get a much more comprehensive stool test and B. Hominis, Candida, Citrobacter Freundii, etc showed up. The GI doctor refused to treat me for them.
Perhaps the doctor thought the bacteria you mention are harmless or even good for you


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#517141 - 05/18/17 02:46 AM Re: Recent advances in understanding spondyloarthritis [Re: DavidP]
DavidP Offline
Master_Sergeant_AS_Kicker

Registered: 09/24/07
Posts: 604
Loc: Sale, Victoria, Australia
Hi Robin_H and Frederick,

Blastocystis hominis is a parasite - it's diagnostic significance is debatable. Some labs only report it when profuse, others report it on the understanding that it my be an indicator of other more pathogenic parasites like Giardia.
Candida species can also be considered normal, and if abnormal would probably only be when profuse.
Citrobacter freundii is also probably considered normal.
Most pathology labs are ONLY looking for pathogenic bacteria such as Salmonella, Shigella, Campylobacter, Cholera, Clostridium difficlile and a collection of parasites.
However, in the SpA's and Crohns, what are usually considered 'normal' flora become pathogens - but a lab can't easily decide this.

from the report ..... However, when instead bacteria that had acquired a coating of IgA were investigated, there was an increase in the abundance of Enterobacteriaceae (Kleb. pneumoniae is in this Family) in patients with arthritis, and specifically of adherent-invasive strains of Escherichia coli. Whilst the result was statistically significant, the difference was largely due to much higher levels in approximately one-third of those with arthritis. It has previously been shown that IgA coating of bacteria is a good marker of those species within the gut flora that have engaged the attention of the immune system and are therefore more likely to be pathogenic. Additional evidence of the possible effects of these strains of E. coli came from studies in mice in which the bacteria were shown to exacerbate various IL-23-driven pathologies, including arthritis and colitis. This is a provocative and initial report, and it will be interesting to see the same approach applied to additional cohorts of SpA patients. SpA has long been associated with elevated levels of IgA, with raised IgA specific for the enteric triggers of reactive arthritis being especially notable.
_________________________
Dx Oct 2006 B27+ undifferentiated spondlyarthropathy (uSpA) with mild sebhorrhoeic dermatitis and mild Inflammatory Bowel Disease (IBD) controlled by NSD since 2007.

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#517142 - 05/18/17 03:04 AM Re: Recent advances in understanding spondyloarthritis [Re: DavidP]
DavidP Offline
Master_Sergeant_AS_Kicker

Registered: 09/24/07
Posts: 604
Loc: Sale, Victoria, Australia
Robin_H

That's a great story about the panel of doctors ready to 'treat' you.

When my brother took a copy of Carol Sinclair's "The IBS Low-Starch Diet" to his local doctor the book came flying back across the desk with a comment to effect - 'I'm a man of science - I don't read ---- like that"
_________________________
Dx Oct 2006 B27+ undifferentiated spondlyarthropathy (uSpA) with mild sebhorrhoeic dermatitis and mild Inflammatory Bowel Disease (IBD) controlled by NSD since 2007.

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#517145 - 05/19/17 05:43 AM Re: Recent advances in understanding spondyloarthritis [Re: DavidP]
Frederick Offline
First_Degree_AS_Kicker

Registered: 03/28/06
Posts: 161
Originally Posted By DavidP


When my brother took a copy of Carol Sinclair's "The IBS Low-Starch Diet" to his local doctor the book came flying back across the desk with a comment to effect - 'I'm a man of science - I don't read ---- like that"


I rather agree with the doctor on this one

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#517161 - 05/26/17 05:48 PM Re: Recent advances in understanding spondyloarthritis [Re: DavidP]
Robin_H Offline
Apprentice_AS_Kicker

Registered: 09/13/15
Posts: 92
Loc: Hubei, China
Originally Posted By DavidP
Hi Robin_H and Frederick,

... , in the SpA's and Crohns, what are usually considered 'normal' flora become pathogens - but a lab can't easily decide this. ....

It has previously been shown that IgA coating of bacteria is a good marker of those species within the gut flora that have engaged the attention of the immune system and are therefore more likely to be pathogenic. .... . SpA has long been associated with elevated levels of IgA, with raised IgA specific for the enteric triggers of reactive arthritis being especially notable.


Hi DavidP:

I assume that identifying bacteria that has IgA attached to it is only done in studies and not by doctors on regular patients.
_________________________
HLA-B27 neg; Mis-diagnosed with fibromyalgia in mid-20s.
Vague AS symptoms in 20s and early 30s (no diagnosis).
During age 47 (2015) from NSAID use developed complete axial inflammation (started from from skull and progressed down to sacrum). Included psoriasis. Trigger in scull was reverse blockage in a SCUBA mishap in 2013. Straw that broke the camels back was over use of NSAIDs. NSD works well but not perfect. Strong involvement between symptoms and gut integrity.

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#517170 - 05/28/17 02:33 AM Re: Recent advances in understanding spondyloarthritis [Re: Robin_H]
DavidP Offline
Master_Sergeant_AS_Kicker

Registered: 09/24/07
Posts: 604
Loc: Sale, Victoria, Australia
A conventional pathology lab couldn't identify gut bacteria coated in IgA; it would be definitely something for a specialist or research lab.
_________________________
Dx Oct 2006 B27+ undifferentiated spondlyarthropathy (uSpA) with mild sebhorrhoeic dermatitis and mild Inflammatory Bowel Disease (IBD) controlled by NSD since 2007.

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