SAT0003 Intestinal colonisation with sulphate-reducing bacteria: a co-factor in the aetiopathogenesis of ankylosing spondylitis?
SM Stebbings, J Highton, G Tannock
Speaker abstracts 2001
Exercise alone can produce adequate relief of symptoms in ankylosing spondylitisi (AS) and manipulative therapy has also been shown to improve range of movement in short ? time. Objectives To compare the effect of a dynamic individual rehabilition regimen with a simple conservative exercise regimen (exercies in goups). Methods Forty patients with established AS, mean age 51 years and mean disease duration 10 years were randomly assigned to group of 20 patients each. The treatment programme
... sted of two thre ? months periods.: A. Intensive individual programme (assisted by an experienced physiotherapist) included thermotherapy. Soft techniques, relaxation of shortened muscles, breathing exercises. B. Current exercise programme in groups. Metrologic assessment and questionnaires were used to evaluate the activity of the process (BASDAI) and the functional handicap of the patient (BASFI). In the first group of patients both the programme A and B were applied. The second group underwent only programme B. After 3 months the therapeutic programmes in the two groups were exchanged. Results The combined exercise regimen involving individual therapeutic care resulted in improvement of parameters assessing spinal column mobility ? Schober¨s distance, tips to the floor distance, incluination and retro ? and anteflexion of cervical column. The indicators of function and disease activity evaluated according to BASDAI and BASFI questionnaires showed also improvement but the differences did no reach statistical significance over the three-months period of follow-up. Conclusion Intensive individual exercise programme including soft techniques and relaxation of shortened muscles is more effective in AS than a conservative programme based on exercise in groups. Background Sulphate-reducing bacteria (SRB) have only recently been identified as a constituent of the normal colonic microflora humans. Such colonisation however is far from universal. Small studies in patients with ulcerative colitis (UC) have found SRB to be present in up to 92% of patients and a pathogenic role has been speculated. Approximately 65% of patients with ankylosing spondylitis (AS) have colonic inflammation, and this is now recognised as an independent risk factor for the disease. Furthermore, studies in germfree HLA-B27 transgenic rats have shown that the normal intestinal microflora is essential to the development of spondyloarthritis in these animals. Objectives We aimed to discover whether intestinal colonisation with SRB was more common in AS patients than controls, and thus whether SRB may play a role in the aetiology of AS.