The Importance of HLA-B27 in the Evolution of Reactive Arthritis

Reactive arthritis is an inflammatory joint disease which develops after 1-4 weeks following an enteral, genital or ORL infection, with a higher frequency in HLA-B27 positive patients.

The objective of this paper is to study the importance of HLA-B27 antigen in the development of reactive arthritis.

The transversal, observational study was conducted in the Rheumatology Clinic of the University of Medicine and Pharmacy of Craiova during the period 2012-2015 and included 112 patients. They were divided into three groups, as follows: group I (52 reactive arthritis cases), group II (30 other spondyloarthritis cases), group III (40 osteoarthritis cases). ELISA and PCR techniques were used to determine the antigen.

Those whom had this genetic marker present, the number of enthesitis almost doubled highlighting a possible correlation between the antigen and these imaging changes. We can confirm the same thing for the erosions as well. Unlike enthesitis, erosions occurred also in group III (37.5%), but if we refer to the first two groups, we will observe a significant relationship regarding HLA-B27. More specifically, in HLA-B27 positive patients (68.97%), erosions were found to be twice as numerous than in HLA-B27 negative patients (31.03%). In group I we identified stage 2 sacroiliitis in 68% of HLA-B27 positive patients and 32% in HLA-B27 negative, which shows another link to this antigen with both joint destruction and a possible unfavorable evolution of reactive arthritis.

This antigen specific to the seronegative group of spondyloarthritis determines the acceleration of articular destruction, translated by erosion, and the evolution of sacroiliitis to a more advanced stage.