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The major histocompatibility complex
Insights
This study reveals strong links between specific Human Leukocyte Antigen (HLA) markers and spondyloarthropathies, particularly psoriatic arthritis. HLA B27 is strongly associated with spinal involvement in these conditions.
Area of Science:
- Immunogenetics
- Rheumatology
- Human Leukocyte Antigen (HLA) System
Background:
- The Human Leukocyte Antigen (HLA) system, controlled by the major histocompatibility complex, involves cell surface antigens crucial for transplantation and disease association.
- Spondyloarthropathies, including ankylosing spondylitis, Reiter's syndrome, psoriatic arthritis, and inflammatory bowel disease-associated arthritis, show a close association with specific HLA antigens.
Purpose of the Study:
- To investigate the prevalence of specific HLA antigens in patients with seronegative arthritis.
- To determine the association of HLA antigens with different types of spondyloarthropathies and clinical manifestations like spinal involvement.
Main Methods:
- Clinical and radiographic evaluation of 310 unrelated Caucasian patients with seronegative arthritis.
- HLA-A, B, C, and DR typing using the microdroplet lymphocyte cytotoxicity test.
Main Results:
- Statistically increased prevalences of HLA-A26, HLA-B27, and HLA-Bw38 were observed.
- HLA-B27 was significantly associated with spinal involvement (90% in ankylosing spondylitis, p < 0.0001).
- HLA-A26 and HLA-Bw38 were found in 23% (p < 0.001) and 38% (p < 0.0001) of psoriatic arthritis patients, respectively.
- HLA-DRw4 and HLA-DRw7 were increased in psoriatic arthritis patients (52%, p < 0.03 and 39%, p < 0.04).
- HLA-B7 was frequently observed in spondyloarthritis patients with spinal involvement who lacked HLA-B27.
Conclusions:
- The study reinforces the significant association between specific Human Leukocyte Antigen (HLA) antigens and the development of spondyloarthropathies.
- Specific HLA markers like B27, A26, Bw38, DRw4, and DRw7 are linked to different forms and manifestations of spondyloarthropathies.
Abstract:
The major histocompatibility complex on the sixth chromosome controls expression of a complex series of cell surface antigens which comprise the human leukocyte antigen (HLA) system. These markers, beyond their importance in human organ transplantation, have been demonstrated to occur with an increased prevalence in certain disease states. The group of conditions showing the closest association with specific HLA antigens are the "spondyloarthropathies." These include ankylosing spondylitis (AS), Reiter's syndrome (RS), psoriatic arthritis (PsA), and the arthritis of inflammatory bowel disease (AIBD). Clinical and radiographic studies were made of 310 unrelated caucasoid patients with seronegative arthritis. HLA-A, B, C, and DR typing were performed using the microdroplet lymphocyte cytotoxicity test. Statistically increased prevalences of A26, B27, and Bw38 were observed, while B27 was associated with spinal involvement regardless of diagnosis (90 percent in AS p less than 0.0001). Experiments found A26 (23 percent p less than 0.001) and Bw38 (38 percent p less than 0.0001) in patients with PsA. Spondyloarthritis patients with spinal involvement who lacked B27 frequently had B7. The HLA DR typing for seven specificities was carried out in 196 patients. It was found that DRw4 (52 percent p less than 0.03) and DRw7 (39 percent p less than 0.04) were increased in the PsA patients. This study further confirms the close association of HLA antigens and the spondylarthropathies.