Causal relationship between ankylosing spondylitis and multiple sclerosis: Evidence from 2-sample Mendelian

Rui Liu1, Gang Peng2, Yongbing Xiao1

  • 1Department of Orthopedics, Xiangya Hospital of Central South University, Changsha, Hunan Province, China.

Medicine
|September 24, 2025
PubMed

Insights

Ankylosing spondylitis (AS) may increase the risk of developing multiple sclerosis (MS). This study found a potential causal link from AS to MS, but not the reverse, offering insights into shared disease pathways.

Area of Science:

  • Immunology
  • Genetics
  • Epidemiology

Background:

  • Ankylosing spondylitis (AS) and multiple sclerosis (MS) are chronic immune-mediated diseases.
  • These conditions share overlapping epidemiological and genetic characteristics.
  • The causal relationship between AS and MS is not well understood.

Purpose of the Study:

  • To investigate the potential causal effect of ankylosing spondylitis on the risk of multiple sclerosis.
  • To explore the genetic architecture and pathophysiological pathways shared between AS and MS.

Main Methods:

  • A 2-sample Mendelian randomization (MR) analysis was conducted.
  • Genome-wide association study (GWAS) summary statistics from European populations were utilized.
  • Instrumental variables were selected based on stringent significance, independence, and validity criteria.

Main Results:

  • The primary MR analyses indicated that AS is associated with an increased risk of MS (OR = 2.18).
  • The MR Egger method supported this finding, and sensitivity analyses confirmed the robustness of the results.
  • Inverse MR analysis showed no evidence of a causal effect of MS on AS.

Conclusions:

  • Ankylosing spondylitis may causally influence the risk of developing multiple sclerosis.
  • These findings contribute to understanding the shared genetic and pathophysiological links between AS and MS.
  • Further research in diverse populations and using nonlinear models is recommended.

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