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Raised incidence of ankylosing spondylitis among Inuit populations could be due to high HLA-B27 association and starch consumption

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Abstract

Ankylosing spondylitis (AS) is a chronic inflammatory arthritis mainly affecting the spinal joints. It would appear that the most likely causative agent in the development of AS is an environmental factor in the genetically susceptible, HLA-B27 positive, individuals. Extensive data from several countries support the notion that Klebsiella pneumonia bacteria are the most likely culprit in the causation of AS. These microbes possess antigens which resemble HLA-B27 and spinal collagens. Increased intake of high-starch diet is directly proportional to the gut-associated bacterial load, especially in the large intestine, and among these microbial agents, Klebsiella is considered as one of the main constituting components. Therefore, a low-starch diet intake alongside the currently used medical therapeutic modalities could be beneficial in the management of patients with early AS. It is suggested that a change in the dietary habits from high protein, low-starch marine components to the Westernized high-starch diet among the Inuit peoples of Alaska and Canada could be considered as one of the main contributing factors in the increased prevalence of AS during the last few decades within this genetically unmixed native population.

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Acknowledgments

We thank the Trustees of the Middlesex Hospital, the Arthritis Research Campaign and the “American Friends of King’s College London” for their financial supports.

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The authors declare that they have no conflict of interests.

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  1. Analytical Sciences Group, Kings College London, 150 Stamford Street, London, SE1 9NH, UK

    Taha Rashid & Alan Ebringer

  2. Department of Microbiology, King Edward VII Memorial Hospital, Hamilton, Bermuda

    Clyde Wilson

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  1. Taha Rashid
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Correspondence to Alan Ebringer.

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Rashid, T., Wilson, C. & Ebringer, A. Raised incidence of ankylosing spondylitis among Inuit populations could be due to high HLA-B27 association and starch consumption. Rheumatol Int 35, 945–951 (2015). https://doi.org/10.1007/s00296-014-3164-2

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