Activity of Humoral Antiendotoxin Immunity Is Associated with Low-Intensity Inflammation and Oxidative Stress in Ankylosing Spondylitis: Endotoxin Component of Disease Pathogenesis

Clinical and laboratory examination was performed for 50 patients with ankylosing spondylitis (AS) (mean age 38.1 ± 1.3 years) with degree II of general activity of the pathological process and disease history of 1–8 years (mean BASDAI score 3.6 ± 0.2). Close relationships between the level of oxidative stress, the severity of low-intensity inflammation, and the activity of the humoral component of anti-endotoxin immunity were observed in the active phase of AS, implicating endotoxin aggression of intestinal origin in disease pathogenesis. Based on cluster analysis, a deficiency of class M anti-endotoxin antibodies was associated with a higher level of oxidative stress and low-intensity inflammation in the AS patients. Medical procedures and drugs that can normalize systemic endotoxemia were therefore considered advisable to include in AS treatment. The anti-endotoxin component of the treatment is expected to increase the treatment efficacy and to reduce the need for cytostatics and, therefore, their iatrogenic side effects.