1974;1:956–8. Nasution AR, Mardjuadi A, Suryadhana NG, et al. Baseline and 1-year magnetic resonance imaging of the sacroiliac joint and lumbar spine in very early inflammatory back pain. 489 0 obj <> endobj 0000005140 00000 n 2010;62:1236–45. 0000016964 00000 n Non-synonymous nucleotide substitutions affecting the antigen-binding cleft can lead to differences in antigen presentation and ultimately in disease association [34]. Boyer GS, Templin DW, Cornoni-Huntley JC, Everett DF, Lawrence RC, Heyse SF, Miller MM, Goring WP. 2016;55(2):221–9. HLA-B27 and Autoimmune Diseases Infect Immun. The B*27:05 and C*01:02 alleles were associated with enthesitis in PsA. Sugisaki K, et al. Arthritis Rheum. Molecular mimickry between HLA B27 and Yersinia, Salmonella, Shigella and Klebsiella within the same region of HLA α1-helix. TNFi response was not associated with the presence of shared epitopes but rather with amino acid position 11. http://emedicine.medscape.com/article/1790189-overview. A gender-specific distribution of HLA alleles has been described: female patients with celiac disease are infrequently DQ2.5/DQ8-negative. Consequences for spondyloarthropathies. Arthritis Rheumatol. Basically, the HLA-B27 tests may help to monitor all the progression of these and other autoimmune diseases. Curr Rheumatol Rep. 2013;15:344. Testing could also be considered in case of unexplained iron deficiency anemia or early onset osteoporosis [116, 117]. Ann Rheum Dis. Kuranov AB, et al. Ethnic differences seem to exist regarding disease susceptibility conferred by HLA-B27. The unfolded protein response hypothesis is based on the ability of HLA-B27 heavy chains to form stable homodimers owing to the free thiol groups of Cys67 [33]. Q: What is the significance of ANA patterns? Arthritis Rheumatol. The human leukocyte antigen (HLA) system, which corresponds to the major histocompatibility complex (MHC) in humans, plays a pivotal role in the antigen presentation of intracellular and extracellular peptides and the regulation of innate and adaptive immune responses. Thirty to eighty percent of patients with reactive arthritis (ReA) and 20–35% of patients with psoriatic arthritis are HLA-B27 positive [22, 23]. 2003;100(21):12390–5. Schiellerup P, Krogfelt KA, Locht H. A comparison of self-reported joint symptoms following infection with different enteric pathogens: effect of HLA-B27. 2015;54:286–9. Therefore, the diagnostic role of HLA B27 is mostly to support the clinical suspicion of SpA in addition to providing prognostic information. Curr Rheumatol Rep. 2014;16(6):421. Azizlerli G, Kose AA, Sarica R, Gül A, Tutkun IT, Kulaç M, et al. Stastny P. Mixed lymphocyte cultures in rheumatoid arthritis. Comparison of two referral strategies for diagnosis of axial spondyloarthritis: the Recognising and Diagnosing Ankylosing Spondylitis Reliably (RADAR) study. Clin Rheumatol. Celiac disease genetics: current concepts and practical applications. On the other hand, TNF-alpha inhibitors show a greater therapeutic effect in HLA-B27-positive patients with AS [68, 69]. Ortiz-Fernández L, Carmona F-D, Montes-Cano M-A, et al. 0000022536 00000 n These findings suggest that HLA-B51 is involved in the activation of CD8-positive T-cells, gamma-delta T-cells, NK-cells, and neutrophils. This leads the authors to the conclusion that HLA-B27 positivity might also play a role in persistent arthralgia following Chikungunya infection; its importance, however, remains to be seen [79]. J Pediatr Gastroenterol Nutr. 1991;50:351–3. HLA-B27 and its subtypes in world populations. 0000009687 00000 n Br J Rheumatol. 1973;288:704–6. Interestingly, only changes of the latter three affect the shared epitope motif. Association of HLA B27 With Benign clinical course of nephropathia epidemica caused by puumala hantavirus. Prevalence of Behçet's disease in Istanbul, Turkey. Kim TJ, Na KS, Lee HJ, Lee B, Kim TH. Different haplotypes recognize different ligands with different affinity, resulting in different risk profiles. Patients with valine at this position had significantly better EULAR responses independent of zygosity and ACPA status compared to noncarriers [134, 144]. Bennett AN, et al. Identification of multiple risk variants for ankylosing spondylitis through high-density genotyping of immune-related loci. Note: At Quest Diagnostics each pattern is reported if more than one is observed. Relationships of HLA-B51 or B5 genotype with Behçet's disease clinical characteristics: systematic review and meta-analyses of observational studies. Shared epitopes are associated significantly only with ACPA-positive RA [136]. MacGregor A, Ollier W, Thomson W, Jawaheer D, Silman A. HLA-DRB1* 0401/0404 genotype and rheumatoid arthritis: increased association in men, young age at onset, and disease severity. HLA testing may also be useful to exclude CD in high-risk individuals, such as first-degree relatives of CD patients, patients with autoimmune diabetes mellitus, selective IgA deficiency, Down syndrome, Turner syndrome, Williams syndrome, or autoimmune thyroiditis. Pharmacogenetics of etanercept in rheumatoid arthritis. J Natl Med Assoc. Lancet. Role of Human Leukocyte Antigens (HLA) in Autoimmune Diseases, http://emedicine.medscape.com/article/1790189-overview, http://creativecommons.org/licenses/by-nc/4.0/, https://doi.org/10.6084/m9.figshare.5901163, https://creativecommons.org/licenses/by/4.0, https://doi.org/10.1007/s40744-018-0100-z. 2012;38(3):441–76. Yang T, Duan Z, Wu S, Liu S, Zeng Z, Li G, et al. The risk of HLA-B27-positive individuals to develop ReA is 5–10 times greater than that of the general population [29]. 1986;293(6556):1209 (Clinical research ed).
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