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Long F, Wang T, Li Q, Xiong Y, Zeng Y. Association between Klebsiella pneumoniae and ankylosing spondylitis: A systematic review and meta-analysis. Int J Rheum Dis 2022; 25:422-432. [PMID: 35019225 DOI: 10.1111/1756-185x.14283] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 12/12/2021] [Accepted: 01/02/2022] [Indexed: 02/05/2023]
Abstract
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.
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Affiliation(s)
- Fayu Long
- Department of Orthopedics, Chengdu Second People's Hospital, Chengdu, China
| | - Taiping Wang
- Department of Orthopedics, Chengdu Second People's Hospital, Chengdu, China
| | - Qing Li
- Department of Orthopedics, Chengdu Second People's Hospital, Chengdu, China
| | - Yiquan Xiong
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yong Zeng
- Department of Orthopedics, Chengdu Second People's Hospital, Chengdu, China
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2
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Genome analysis of
Klebsiella oxytoca
complex for antimicrobial resistance and virulence genes. Antimicrob Agents Chemother 2022; 66:e0218321. [PMID: 35007133 DOI: 10.1128/aac.02183-21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Klebsiella oxytoca
complex comprises nine closely-related species causing human infections. We curated genomes labeled
Klebsiella
(n=14,256) in GenBank and identified 588 belonging to the complex, which were examined for precise species, sequence types, K- and O-antigen types, virulence and antimicrobial resistance genes. The complex and
Klebsiella pneumoniae
share many K- and O-antigen types. Of the complex,
K. oxytoca
and
Klebsiella michiganensis
appear to carry more virulence genes and be more commonly associated with human infections.
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3
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Nygaard A, Hendricks O, Loft AG, Christiansen AA, Brandslund I, Jurik AG, Schiøttz-Christensen B. Complement C3d is not associated with axial spondyloarthritis and magnetic resonance imaging changes at the sacroiliac joint. Scand J Rheumatol 2021; 51:382-389. [PMID: 34470588 DOI: 10.1080/03009742.2021.1946255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objective: To investigate the associations between complement C3d and inflammatory and structural changes by magnetic resonance imaging (MRI) at the sacroiliac joints (SIJ) suggestive of axial spondyloarthritis, according to the Assessment of SpondyloArthritis international Society (ASAS) criteria, in patients with low back pain.Method: This was a cross-sectional study of patients referred to the Spine Centre of Southern Denmark owing to unspecified low back pain (Spines of Southern Denmark cohort). The patients were divided into three groups: group 1: patients fulfilling the ASAS criteria for axial spondyloarthritis (axSpA, n = 96); group 2: patients with either a positive MRI of the SIJ and no spondyloarthritis features, or a negative MRI of the SIJ but positive human leucocyte antigen-B27 and one spondyloarthritis feature (non-axSpA, n = 38); group 3: patients with unspecified low back pain for > 3 months (control group, n = 82). Complement C3d was measured with double-decker rocket immunoelectrophoresis and evaluated in relation to the group division and baseline findings by SIJ MRI.Results: In total, 184 C3d analyses were performed. The mean ± sd level of C3d was 33.8 ± 8.1 AU/mL. There were no differences in C3d levels between the three patient groups, mean values being: axSpA = 34.3 ± 7.9 AU/mL, non-axSpA = 33.5 ± 6.9 AU/mL, and controls = 33.4 ± 9.2 AU/mL. The level of C3d was not related to MRI findings.Conclusions: In these patients, complement C3d was not associated with active or structural SIJ changes on MRI suggestive of axial spondyloarthritis.
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Affiliation(s)
- A Nygaard
- Lillebaelt Hospital, University Hospital of Southern Denmark, Middelfart, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - O Hendricks
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Department of Rheumatology, The Danish Hospital for Rheumatology, Sonderborg, Denmark
| | - A G Loft
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
| | - A A Christiansen
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Department of Rheumatology, The Danish Hospital for Rheumatology, Sonderborg, Denmark
| | - I Brandslund
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Department of Clinical Immunology and Biochemistry, Lillebaelt Hospital, Vejle, Denmark
| | - A G Jurik
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Radiology, Aarhus University Hospital, Aarhus, Denmark
| | - B Schiøttz-Christensen
- Lillebaelt Hospital, University Hospital of Southern Denmark, Middelfart, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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4
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Kiil RM, Mistegaard CE, Jurik AG, Christiansen AA, Hendricks O, Schiøttz-Christensen B, Loft AG. Diagnosing axial spondyloarthritis by multidiciplinary team conference at 3.5 years' follow-up in a cohort of patients with disease features according to the ASAS criteria. Scand J Rheumatol 2021; 51:291-299. [PMID: 34263690 DOI: 10.1080/03009742.2021.1933584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES During the past two decades, magnetic resonance imaging (MRI) has increasingly been used diagnostically in axial spondyloarthritis (axSpA), and in 2009 MRI was introduced in the Assessment of SpondyloArthritis Society (ASAS) classification criteria. In clinical practice, there is a risk of overdiagnosis if MRI findings are not related to clinical and biochemical findings. The aim of this study was to provide an estimate of the prevalence of axSpA in a cohort of clinical patients with low back pain and findings suggestive of axSpA according to ASAS through consensus diagnosis at a multi-disciplinary team (MDT) conference, and to describe the performance of the features included in the ASAS criteria. METHOD Consensus diagnoses of axSpA at MDT conferences were retrospectively established at 3.5 years' follow-up in a cohort of 84 patients, initially referred with disease features according to the ASAS criteria. Patients were examined clinically regarding spondyloarthritis features, and biochemical tests and MRI of the sacroiliac joints and entire spine were performed at baseline and after a mean of 3.5 years. RESULTS According to the MDT consensus, 25 patients (30%) of the total cohort had axSpA at follow-up; 40% of individuals who fulfilled the ASAS criteria at baseline had axSpA, and 37% at follow-up; 96% of axSpA patients according to the MDT consensus met the ASAS criteria at baseline and 92% at follow-up. CONCLUSION Approximately one-third of the included patients had axSpA when evaluated at the MDT conference. The ASAS criteria had low predictive value, but high sensitivity at both baseline and follow-up.
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Affiliation(s)
- R M Kiil
- Department of Radiology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - C E Mistegaard
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
| | - A G Jurik
- Department of Radiology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - A A Christiansen
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Danish Hospital for Rheumatic Diseases, Sønderborg, Denmark
| | - O Hendricks
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Danish Hospital for Rheumatic Diseases, Sønderborg, Denmark
| | - B Schiøttz-Christensen
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Research Department, Spine Centre of Southern Denmark, Hospital Lillebaelt, Middelfart, Denmark
| | - A G Loft
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
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Abstract
A causal link between the wealth of microbes that populate our body surfaces, designated as microbiota, and inflammatory disorders, including ankylosing spondylitis and the related spondyloarthritis (SpA) has been suspected for decades. This specially concerns the gut microbiota that became only recently accessible to thorough description thanks to massive sequencing methods or metagenomics. Here, we review evidences supporting the existence of microbiota imbalance or dysbiosis in the context of SpA. We also discuss currently existing evidences for a causal relationship between such dysbiosis and disease development, as well as putative therapeutic implications.
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Affiliation(s)
- Maxime Breban
- Infection & Inflammation, UMR 1173, Inserm, UVSQ/Université Paris Saclay, 2 Ave de La Source de La Bièvre, 78180, Montigny-le-Bretonneux, France; Service de Rhumatologie, Hôpital Ambroise Paré, AP-HP, 9 Ave Charles de Gaulle, 92100, Boulogne, France; Laboratoire D'Excellence Inflamex, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
| | - Marie Beaufrère
- Infection & Inflammation, UMR 1173, Inserm, UVSQ/Université Paris Saclay, 2 Ave de La Source de La Bièvre, 78180, Montigny-le-Bretonneux, France; Service de Rhumatologie, Hôpital Ambroise Paré, AP-HP, 9 Ave Charles de Gaulle, 92100, Boulogne, France; Laboratoire D'Excellence Inflamex, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Simon Glatigny
- Infection & Inflammation, UMR 1173, Inserm, UVSQ/Université Paris Saclay, 2 Ave de La Source de La Bièvre, 78180, Montigny-le-Bretonneux, France; Laboratoire D'Excellence Inflamex, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
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6
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Heftdal LD, Loft AG, Hendricks O, Ashouri Christiansen A, Schiøttz-Christensen B, Arnbak B, Jurik AG, Østgård R, Winding Deleuran B, Møller HJ, Greisen SR. Divergent effects on macrophage biomarkers soluble CD163 and CD206 in axial spondyloarthritis. Scandinavian Journal of Clinical and Laboratory Investigation 2018; 78:483-489. [DOI: 10.1080/00365513.2018.1500704] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
| | - Anne Gitte Loft
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
| | - Oliver Hendricks
- King Christian 10th Hospital for Rheumatic Diseases, Gråsten and Hospital of Southern Jutland, Jutland, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Alice Ashouri Christiansen
- King Christian 10th Hospital for Rheumatic Diseases, Gråsten and Hospital of Southern Jutland, Jutland, Denmark
| | - Berit Schiøttz-Christensen
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Spine Centre of Southern Denmark, Hospital Lillebaelt Middelfart, Middelfart, Denmark
| | - Bodil Arnbak
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Department of Radiology, Hospital Lillebaelt, Vejle, Denmark
| | - Anne Grethe Jurik
- Spine Centre of Southern Denmark, Hospital Lillebaelt Middelfart, Middelfart, Denmark
- Department of Radiology, Aarhus University Hospital, Aarhus, Denmark
| | - René Østgård
- Diagnostic Center, Silkeborg Regional Hospital, Silkeborg, Denmark
| | - Bent Winding Deleuran
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Holger Jon Møller
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark
| | - Stinne Ravn Greisen
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
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