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Study links childhood appendicitis to lower risk for developing ankylosing spondylitis

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LONDON — Although appendicitis during childhood was linked with a decreased risk for the development of ankylosing spondylitis later in life, researchers found respiratory tract infections increased the odds of ankylosing spondylitis.

“Inflammatory response to different types of infections during childhood somehow induce some long- lasting immunological changes that later on affect the risk of ankylosing spondylitis in genetically susceptible individuals,” Ulf Lindström, MD, lead study author from the Institute of Medicine, Sahgrenska Academy, University of Gothenburg in Sweden, said in a press conference at the EULAR Annual Congress. “Infections or the treatment of infections alter the balance in the gut flora which may affect the risk or, what might be more probable, [it] could be that the early immune phenotype that eventually leads to ankylosing spondylitis also effects the risk of different infections.”

Ulf Lindström

Lindström and colleagues conducted a register-based study and identified 2,643 cases of ankylosing spondylitis (AS) and 11,064 matched controls. The National Patient Register was used to identify hospitalization with ICD-codes for infections for both cases and controls aged 0 years to 16 years. Investigators used univariate conditional logistic regression analyses to determine the odds ratio for AS development with regard to exposure to different infections.

Results showed the odds for a later diagnosis of AS were reduced by 40% with childhood appendicitis. Investigators discovered hospitalization with a respiratory tract infection increased the odds for AS by 20%. Lindström and colleagues found hospitalization for urogenital or gastrointestinal tract infections did not predict AS diagnosis.

“From this study, it is not possible to discern what the reasons may be, but the results still strengthen our understanding or the theory that there is an interplay between genetics and environmental exposures in the development of ankylosing spondylitis, but it needs to be explored further,” Lindström said. – by Monica Jaramillo

Reference:

Lindström U, et al. Abstract #OP0082. Presented at: EULAR Annual Congress; June 8-11, 2016; London.

Disclosure: Lindström reports no relevant financial disclosures.