Ankylosing spondylitis (AS) is a disabling chronic inflammatory disease that mainly affects the axial skeleton
with a special predilection for the sacro-iliac joints. Extensive evidence shows that Klebsiella pneumonia is the main microbial
triggering factor in AS leading to the development of the full-blown disease after repeated attacks of infections by
this microbe through mechanism of molecular mimicry or cross reactivity. Despite the use of advanced radiological tools,
detection of early cases of AS is difficult and it takes nearly 5 to 10 years until the diagnosis of a classical AS is established,
with as yet no available curative treatment. In the current review paper we present evidence for the role of Klebsiella
microbes in the aetiopathogenesis of AS and discuss a possible new approach for early diagnosis of AS mainly
through the identification of HLA-B27 antigens and Klebsiella antibodies, as well as treatment of AS with “low starch
diet” with or without the use of current therapy.
Keywords: Ankylosing spondylitis, HLA-B27, Klebsiella antibodies, new diagnostic criteria, low starch diet.
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