Home Arthritis Spondylitis – an inflammatory, autoimmune disease

Spondylitis – an inflammatory, autoimmune disease

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Spondylitis, inflammatory, autoimmune disease, ankylosing spondylitis, bones, inherited gene,Axial Spondyloarthritis, rheumatoid arthritis, Systemic inflammatory diseases,T cell activity,HLA-B27 gene,anti-inflammatory, butyrate, Boswellia, ashwagandha, topical CBD, topical Frankincense,Naltrexone
Spondylitis - an inflammatory, autoimmune disease

Spondylitis, also called ankylosing spondylitis, is an inflammatory disease starting in the gut, and leading to an autoimmune response, where the body’s own immune system attacks the bones.

As you will read, an inherited gene plays a role; as does a change of membership of the microbiome, with a reduction of the good bacteria, an increase in inflammatory bacteria and lowered levels of a crucial short chain fatty acid butyrate.

Also called Axial Spondyloarthritis, it is seen as an extreme form of arthritis, akin to rheumatoid arthritis

Spondylitis – not your usual auto-immune disease

Systemic inflammatory diseases often cause an immune response, most usually causing antibodies to be produced. These antibodies may attack another area of the body following inflammation. This is what occurs in the leading autoimmune disease in the Western world, Hashimoto’s, which is a microbiome problem that leads to an attack on the thyroid.. 

Ankylosing spondylitis (AS) seems slightly different in that the inflammation provokes a reaction in the innate immune system causing T cell activity with reaction in lymphoid cells, neutrophils, mucosal-associated T cells and mast cells (1). In spondylitis, this first reaction still occurs in the microbiome, but this prompts an attack on the bones and can cause some of the bones in the spine to be damaged. As they repair, they fuse. 

When this happens in the spine, the patient will develop a stiff back, with pain. The patient will become less flexible. It is possible that the ribs are affected and this can lead to breathing difficulties.

Some Health Websites describe spondylitis as a form of arthritis. Inflammation alone can lead to pain in other joints.

More than 90 percent of people with ankylosing spondylitis carry the HLA-B27 gene, according to the Spondylitis Association of America. It can be more severe in black people (2).

In a 2021 study (3), which focussed on anti-inflammatory (e.g. Bifidobacterium, Lactobacillus, Faecalibacterium prausnitzii) and pro-inflammatory bacteria (e.g. Bacteroides, Escherichia coli) species it was found that the bacterial diversity in the AS group was decreased. In particular there was a significantly decreased level of Clostridium leptum and an increased level of Escherichia coli

Reduced levels of butyrate have been identified in the gut of AS patients (4).

Doctors typically treat the disease through:

  • Pain Management (typically NSAIDs)
  • Corticosteroids and Antirheumatic drugs
  • Flexibility exercises and Lifestyle changes 

Pain relief and anti-inflammatory compounds would involve Boswellia, ashwagandha, topical CBD and topical Frankincense, and Low Dose Naltrexone, also used in cases of Rheumatoid arthritis. We would be looking at supplemental butyrate; and rebuilding the microbiome – killing the bad and replenishing the good. 

Go to: Heal your gut

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References

  1. Ankylosing spondylitis: an autoimmune or autoinflammatory disease?; Daniele Mauro et al; Nat Rev Rheumatol, 2021 Jul;17(7):387-404.
  2. Ethnicity and Disease severity in alkalising spondylitis; Farokh Jamalyaria et al; Springer Nature; 06 August 2017; vol 36, pages 2359-2364
  3. Characteristics of the intestinal microbiome in ankylosing spondylitis; Anca Cardoneanu et al; Exp Ther Med. 2021 Jul; 22(1): 676, Published online 2021 Apr 24. 
  4. ‘All disease begins in the gut’—the role of the intestinal microbiome in ankylosing spondylitis; Patricia Harkins et al; Rheumatol Adv Pract. 2021; 5(3): rkab063; Published online 2021 Sep 11.