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The link between HLA-B27 and SpA--new ideas on an old problem
1Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Oxford, UK.
Rheumatology (Oxford, England)
|April 20, 2012
Summary
The human leukocyte antigen B27 (HLA-B27) is strongly linked to ankylosing spondylitis (AS). Recent advances in GWAS, B27 biology, and biologic therapies offer new insights into AS pathogenesis.
Area of Science:
- Immunogenetics
- Rheumatology
- Genomics
Background:
- The association between HLA-B27 and ankylosing spondylitis (AS) was identified in 1972.
- Despite decades of research, the precise pathogenic role of HLA-B27 in AS remains elusive.
- Recent genome-wide association studies (GWAS) have reconfirmed this strong genetic link.
Purpose of the Study:
- To review recent advancements in understanding HLA-B27 and AS.
- To propose new theories on AS pathogenesis.
- To discuss current models of AS pathogenesis.
Main Methods:
- Review of recent literature on GWAS.
- Analysis of studies on HLA-B27 biology.
- Examination of findings from biologic therapies for AS.
Main Results:
- GWAS have provided sophisticated fine-mapping confirmation of the HLA-B27 association.
- Advances in understanding B27 biology offer potential mechanisms for disease.
- Biologic therapies provide insights into inflammatory pathways in AS.
Conclusions:
- Recent developments offer a new perspective on the HLA-B27 and AS relationship.
- Coherent theories of AS pathogenesis can now be proposed.
- Further investigation into B27 biology and therapeutic responses is warranted.
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