Klebsiella: The Cause of R A and Ankylosing Spondylitis, Part 2

Klebsiella: The Cause of R A and Ankylosing Spondylitis, Part 2

What is Ankylosing Spondylitis?

Ankylosing spondylitis is a chronic Klebsiella infection or inflammation from endotoxins of the axial skeleton and occasionally the joints. Ankylosing spondylitis usually develops from the chronic overgrowth of Klebsiella when one is a young adult, and the symptoms of the disease slowly worsen. Early symptoms of AS include lower back pain, increased curvature of the lower spine, joint pain, stiffness in the lower back, weight loss, fever, and fatigue. Later progression of the disease can cause loss of spinal manipulation, issues with breathing and chest expansion, arthritis in the hips and shoulders, severe pain, and swelling.1 2

AS is diagnosed from radiological imaging to determine function, sclerosis, and erosion of the spine and joints. Inflammatory markers like C-reactive protein, TNF-a, and interferon gamma may increase during acute phases of heavy overgrowth or active infection of Klebsiella and the HLA-B27, HLA-DR4 genes may be tested. Human leukocyte antigen genes are essential in the regulation of our immune system in reaction to the world around us, including pathogens. Mutations in HLA-B27 and HLA-DR4 have been discovered to be linked to increased Klebsiella sensitivity from leaky gut and the development of AS.3 4 5 6

What Is Rheumatoid Arthritis and How Is It Also Caused by Klebsiella?

Rheumatoid arthritis is a chronic Klebsiella infection or inflammation of endotoxins of the joints. Rheumatoid arthritis usually develops from the chronic overgrowth of Klebsiella, and the symptoms of the disease slowly worsen. Symptoms of RA include joint pain, joint stiffness (loss of range of motion), increased joint curvature, cervical spine pain, liver and kidney issues, swelling of joints, rheumatoid nodules on the skin, and dryness of the eyes and mouth. Later progression of the disease can cause severe reduction in joint manipulation, lung fibrosis, crippling pain and swelling in the joints, and heart disease.7 8

RA is diagnosed from radiological imaging to determine function, inflammation, and erosion of joints. Inflammatory markers like C-reactive protein, TNF-a, IL-1, IL-6, and interferon gamma may increase during acute phases of dysbiosis or active infection of bacteria and testing of the genes HLA-B27, HLA-DR4 usually occurs. It is fascinating how mostly the same markers are tested for in people with AS and RA to determine if they are suffering from the different chronic conditions. There are, however, other tests that are run to determine if one has RA. Rheumatoid factor (IgM) is tested in the blood which is linked to being an antibody reaction to Gram-negative (Klebsiella is Gram-negative) bacterial endotoxins. ACPA (anti-citrullinated antibodies) is also tested to determine if you are suffering from RA, but they have been shown to be elevated in Gram-negative bacterial endotoxins as well. Even though, both of these tests are rarely run for people to help diagnose AS, from the evidence we have it appears that people with AS would most likely test positive for these antibodies as well.9 10 11 12 13 14 15

Klebsiella Overgrowth the Cause of Ankylosing Spondylitis and Rheumatoid Arthrits

I mentioned a few clues above that link the bacteria as being the cause of AS and RA. Is it not weird for an “autoimmune” condition to cause a fever during the acute, painful stage? Here is another coincidence: the same inflammatory markers tested for AS and RA are elevated in Th1 dominant immune conditions what are caused by the Gram-negative bacterial genus, Klebsiella. Mutations in HLA-B27 and HLA-DR4 distort a proper immune response to Klebsiella overgrowth. The distortion of immune function can allow for easier Klebsiella overgrowth, or can cause abnormal immune reactions to LPS endotoxins causing Th1 dominance and chronic inflammation in the spine and joints for issues with proper collagen production. Reducing starch in the diet has been demonstrated in studies to reduce Klebsiella populations in the gut and reduce symptoms of AS and RA. Finally, multiple studies have found overgrowth of Klebsiella and increased antibodies to Klebsiella endotoxins in people with AS and RA.16 17 18 19 20

So why do some people with Klebsiella overgrowth develop just gut issues and some develop AS or RA, what is the difference? We all have Klebsiella in our body as natural flora. Are mutations or epigenetic changes in the genes HLA-DR4 and HLA-B27 and possibly other genes the difference in why someone who takes antibiotics long-term or eats a lot of resistant starch eventually develops AS or RA? It is possible. I will go one step further and say that it is even possible for these genes to mutate epigenetically (mutations that occur from the environment). Could a severe overgrowth of Klebsiella itself change one’s genetics making the body more susceptible to it? Klebsiella endotoxins modify the expression of HLA-B27 and HLA-DR4. Klebsiella itself might be able to change the expression of HLA-B27 or HLA-DR4 so that the immune system fails to recognize and control the pathogen leading to excessive inflammation and Th1 dominance. Now you might also be asking yourself, why do some people develop RA, instead of AS or vice-versa if both are caused by Klebsiella? It could depend on many different factors, including, someone’s individual gene expression, what period of their life they developed the overgrowth, their immune system, or the individual strain of Klebsiella that can cause different manifestations of the chronic diseases. Finally, I find it interesting that many people with AS have joint inflammation and pain, whereas most people with RA also have joint curvature and cervical spine pain, almost if both diseases had a similar pathology?21 22 23

The most damning evidence that AS and RA are caused by Klebsiella is that most people die from cardiovascular or pulmonary symptoms. The cardiovascular and pulmonary systems are under constant assault from increased inflammation occurring from Th1 dominance in response to endotoxins produced from Klebsiella, which inflame the arteries, heart, and veins over time. Chronic inflammation from endotoxins produces cardiovascular disease which may eventually lead to heart failure and death. Lung fibrosis is a commonly recognized consequence of having both RA and AS and can lead to cardiopulmonary failure. Klebsiella is known to colonize the lungs easily and is a cause of bacterial pneumonia.24 25 26

Medication that is used in treating AS and RA tackles the symptoms only of the overgrowth but does not reduce it. Opioids help to control the pain that is caused by inflammation and scar tissue caused by the overgrowth. NSAIDS and most biologics hinder the immune system and reduce Th1 dominance which for a time quenches inflammation and reduces damage to the body. However, the bacteria overgrowth worsens from being uncontrolled and most people relapse and inflammation increases which override the medications, causing a vicious cycle of inflammation, scar tissue formation, and pain.27 28

See more from this series:

  1. Beers, Mark. The Merck Manual, Merck Research Laboratories, 2006.
  2. Bauman, Robert. Microbiology with Diseases by Body System, Benjamin Cummins, September 12, 2012.
  3. Beers, Mark. The Merck Manual, Merck Research Laboratories, 2006.
  4. Bauman, Robert. Microbiology with Diseases by Body System, Benjamin Cummins, September 12, 2012.
  5. http://www.discoverymedicine.com/Taha-Rashid/2011/09/12/gut-mediated-and-hla-b27-associated-arthritis-an-emphasis-on-ankylosing-spondylitis-and-crohns-disease-with-a-proposal-for-the-use-of-new-treatment/
  6. http://www.kickas.org/medical/11.shtml
  7. Beers, Mark. The Merck Manual, Merck Research Laboratories, 2006.
  8. Bauman, Robert. Microbiology with Diseases by Body System, Benjamin Cummins, September 12, 2012.
  9. https://www.hindawi.com/journals/jir/2013/872632/
  10. https://www.hindawi.com/journals/ad/2012/539282/
  11. https://www.ncbi.nlm.nih.gov/pubmed/3046829
  12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4246018/
  13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4847317/
  14. https://www.ncbi.nlm.nih.gov/pubmed/9177924
  15. https://www.ncbi.nlm.nih.gov/pubmed/23141717
  16. http://www.discoverymedicine.com/Taha-Rashid/2011/09/12/gut-mediated-and-hla-b27-associated-arthritis-an-emphasis-on-ankylosing-spondylitis-and-crohns-disease-with-a-proposal-for-the-use-of-new-treatment/
  17. http://www.kickas.org/medical/11.shtml
  18. http://www.ncbi.nlm.nih.gov/pubmed/9973159
  19. http://perfecthealthdiet.com/2014/11/update-attacking-ankylosing-spondylitis-phd/
  20. http://thegutinstitute.com/2014/10/dont-take-raw-potato-starch-rps-temporarily-if-you-have-an-autoimmune-disorder-part-5.html
  21. http://www.discoverymedicine.com/Taha-Rashid/2011/09/12/gut-mediated-and-hla-b27-associated-arthritis-an-emphasis-on-ankylosing-spondylitis-and-crohns-disease-with-a-proposal-for-the-use-of-new-treatment/
  22. http://www.kickas.org/medical/11.shtml
  23. http://www.ncbi.nlm.nih.gov/pubmed/26659265
  24. http://emedicine.medscape.com/article/219907-overview
  25. http://www.ncbi.nlm.nih.gov/pubmed/17510602
  26. http://www.medpagetoday.com/rheumatology/backpain/53432
  27. Beers, Mark. The Merck Manual, Merck Research Laboratories, 2006.
  28. Bauman, Robert. Microbiology with Diseases by Body System, Benjamin Cummins, September 12, 2012.
11 Comments
  1. Will you follow this up with a 3rd installment? I just had a stool test done and have a massive klebsiella population. I also have RA and am suspecting AS as well, as symptoms are increasing/changing pretty rapidly. I have more doc appointments coming up soon. Anyway, your articles are very informative and I’m looking for more, what to do from here. Thank you for sharing your knowledge!

  2. Does this imply that A.S. is reversible by treating the klebsiella overgrowth and reestablishing balanced flora?

  3. Where is the klebisella that causes AS inflammation primarily located (colon, small intestines, illeum, etc.)?

  4. Oh yeah, quick question: Would sweet rice/glutinous rice (https://en.wikipedia.org/wiki/Glutinous_rice) be better than jasmine rice (well-chewed) for KP overgrowth? It has little to no amylose and high amylopectin. From my limited understanding, that means sweet rice would be better?

  5. Great follow-up article!

    Didn’t know about epigenetic changes/mutations KP can potentially exert on the genome. If that were true, is there any way to reverse them?

    Also, is there a reason AS seems to affect males and certain populations (Asians, Native Americans, Caucasians, etc) more?

    Looking forward to the rest of the series.

    Bobby

    • Possibly by reducing the overgrowth of Gram-negative bacteria, increasing endogenous vitamin D, and reducing Th1 inflammation, the genes can be influenced in a more positive light.

      Probably, genetic weaknesses to the endotoxins per genetic populations.

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