Just my opinion here - I think that one aspect that is sometimes overlooked in the molecular mimicry theory is the role of gut permeability. If the gut wall is healthy then the bacteria inside do not come under attack from the immune system. So there are two important factors - the amount of klebs in the gut and also the permeability of the gut. So a flare up could occur independent of starch intake e.g. through food poisoning or stress. Even the most strict NSD'ers still have klebs in the gut but much fewer and less active klebs.
I think that sometimes too much emphasis is placed on eliminating absolutely all sources of starch rather than putting equal effort into both parts of the equation. Remember that the vast majority of hla-b27 people do not develop full blown AS but half of them will experience periods of intense lower back pain that improves with exercise and worsens on resting (my Dad falls into this category). This could be explained by a temporary increase in gut permeability that resolves itself quickly.
So whats the difference between two hla-b27+ individuals, one with AS and one without? Gut health and possibly also other favourable genes that modulate the disease. I think that sometimes people don't get very good results with the diet because they are still taking things that can damage the gut like NSAID's, coffee, alcohol, lots of dairy etc. Even with all this though there are still people who have tried the diet + gut friendly stuff and still not seen results like Drizzit & Kat. There are still plenty of unknowns and every person is different.
Just my 2 cents though. I am open to criticism and discussion.
