Human leucocyte antigen-B27 testing in clinical practice: a global perspective.

Area of Science:

• Immunogenetics
• Rheumatology
• Bone Biology

Background:

• The association between human leucocyte antigen (HLA)-B27 and spondyloarthritis (SpA) has been recognized for decades.
• Recent research has elucidated novel pathophysiological pathways involving HLA-B27 in SpA.
• This review focuses on recent advancements in understanding HLA-B27's role in bone formation within SpA.

Approach:

• Review of recent scientific literature on HLA-B27 and SpA.
• Analysis of genetic associations and their global variations.
• Exploration of the interplay between genetic factors, gut dysbiosis, and disease predisposition.
• Investigation of HLA-B27's impact on SpA diagnosis, phenotype, and radiographic damage.

Key Points:

• Global association of HLA-B27 with SpA varies significantly by population.
• Genetic scores and the interaction of genetic background with gut dysbiosis are crucial for SpA susceptibility.
• HLA-B27 influences SpA diagnosis, phenotype, and notably, contributes to sacroiliac joint damage and spinal bone formation.
• New studies indicate HLA-B27's role in radiographic damage and bone formation progression in SpA.

Conclusions:

• Recent findings deepen the understanding of HLA-B27's role in SpA pathophysiology.
• HLA-B27 is implicated in disease-related bone formation in SpA.
• These insights may facilitate the development of novel therapeutic targets for SpA.