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Acute anterior uveitis and HLA-B27 subtypes
P J Derhaag1, L P de Waal, A Linssen
1Netherlands Ophthalmic Research Institute, Amsterdam.
Investigative Ophthalmology & Visual Science
|July 1, 1988
Summary
The human leukocyte antigen B27 (HLA-B27) is linked to acute anterior uveitis (AAU), but specific subtypes do not appear to increase disease risk. Most HLA-B27 positive individuals do not develop AAU, suggesting other factors are involved.
Area of Science:
- Immunogenetics
- Ophthalmology
- Rheumatology
Background:
- The human leukocyte antigen B27 (HLA-B27) is strongly associated with acute anterior uveitis (AAU), a common form of intraocular inflammation.
- Despite a high prevalence of HLA-B27 in AAU patients (50%) compared to the general population (8%), only a small fraction (approx. 1%) of HLA-B27 positive individuals develop AAU.
- This discrepancy suggests that specific HLA-B27 subtypes might influence disease susceptibility.
Purpose of the Study:
- To investigate whether specific serologically defined subtypes of HLA-B27 are associated with the development of acute anterior uveitis (AAU).
- To determine if HLA-B27 subtypes show differential frequencies in patients with AAU, with or without co-existing ankylosing spondylitis (AS).
Main Methods:
- Lymphocytes from 36 HLA-B27 positive AAU patients (20 with concurrent ankylosing spondylitis) were analyzed.
- The study focused on three serologically defined HLA-B27 subtypes: B27 W, B27 K, and B27 non W/non K.
Main Results:
- The frequencies of the studied HLA-B27 subtypes were found to be similar in AAU patients and the general population.
- No specific HLA-B27 subtype showed a preferential association with AAU.
- Subtype frequencies in patients with both AAU and ankylosing spondylitis also did not indicate a preference for a particular subtype.
Conclusions:
- The study concludes that subtype-specific characteristics of the HLA-B27 molecule's primary structure are unlikely to be responsible for the disease association with AAU.
- The findings suggest that other genetic or environmental factors, rather than specific HLA-B27 subtypes, play a crucial role in the pathogenesis of AAU in HLA-B27 positive individuals.