INCREASED JEJUNAL SECRETORY IGA AND IGM IN ANKYLOSING-SPONDYLITIS - NORMALIZATION AFTER TREATMENT WITH SULFASALAZINE

Objective. To investigate the intestinal immune system in patients wit h ankylosing spondylitis (AS) and the influence of sulfasalazine treat ment. Methods. Total IgA, secretory IgA and IgM and secretory componen t were determined in jejunal perfusion fluid in 19 patients with AS be fore and after 3 months' treatment with sulfasalazine and compared wit h 18 healthy control subjects. Serum immunoglobulins and inflammatory activity were measured with standard methods and compared with a clini cal scoring of disease activity. Results. Total IgA, secretory IgA, Ig M and secretory component were significantly increased in the lavage f luid when compared with healthy controls. Treatment with sulfasalazine normalized these alterations. Conclusion. Our findings demonstrate th at the intestinal immune system is activated in AS and that such activ ation can be influenced by treatment. This observation supports the id ea that antigenic stimulation in the gut is a possible causative event in AS.