Ethnic Influence in Clinical and Functional Measures of Brazilian Patients with Spondyloarthritis

Skare, Thelma Larocca; Bortoluzzo, Adriana Bruscato; Gonçalves, Célio Roberto; Silva, José Antonio Braga da; Ximenes, Antônio Carlos; Bértolo, Manoel Barros; Ribeiro, Sandra Lúcia Euzébio; Keiserman, Mauro Waldemar; Menin, Rita; Carneiro, Sueli; Azevedo, Valderílio Feijó; Vieira, Walber Pinto; Albuquerque, Elisa N.; Bianchi, W.; Bonfiglioli, Rubens; Campanholo, Cristiano; Carvalho, Hellen M.S.; Costa, Izaías Pereira da; Duarte, Angela P.; Gavi, M.B.R.O.; Kohem, Charles Lubianca; Leite, Nocy; Lima, Sonia A.L.; Meirelles, Eduardo S.; Pereira, Ivânio Alves; Pinheiro, Marcelo M.; Polito, Elizandra; Resende, Gustavo Gomes; Rocha, Francisco Airton Castro; Santiago, Mittermayer Barreto; Sauma, Maria de Fátima Lobato da Cunha; Sampaio-Barros, Percival D.

doi:10.3899/jrheum.110372

Cited by 24 publications

(18 citation statements)

References 27 publications

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“…Second, HLA‐B*2704 was the main HLA‐B27 subtype in our Chinese population, but HLA‐B*2705 was the most common subtype in the Indian and Korean populations. Thus, the ethnic or genetic backgrounds of the different populations, combined with the different relative frequencies of HLA‐B*2704 and HLA‐B*2705 in the different groups may have affected the results. Third, environmental factors may also play a role in the incidence of uveitis .…”

Section: Discussionmentioning

confidence: 99%

Higher risk of uveitis and dactylitis and older age of onset among ankylosing spondylitis patients with HLA‐B2705* than patients with HLA‐B2704* in the Chinese population

Liao

et al. 2013

Tissue Antigens

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Human leukocyte antigen (HLA)-B27 is closely associated with ankylosing spondylitis (AS). However, the exact correlation between HLA-B27 subtypes and AS manifestations remains unknown. This study aimed to investigate the correlation between HLA-B27 polymorphism and the clinical features of AS. This study included 846 patients with AS and 959 healthy controls. Direct sequencing was used to identify the HLA-B27 genotype. Clinical parameters, including age, age of onset, family history, low back pain, peripheral arthritis, hip joint involvement, dactylitis, uveitis, and sex ratio, were compared among patients with various HLA-B27 subtypes. In total, 741 AS patients (87.6%) and 39 healthy controls (4%) were HLA-B27-positive. The most prevalent subtypes were HLA-B*2704 (88%) and HLA-B*2705 (10.1%) in patients with AS. Compared with HLA-B*2704-positive patients, HLA-B*2705-positive patients demonstrated a significant increase in the incidence of uveitis (16% vs 6.13%, P = 0.002) and dactylitis (9.3% vs 3.8%, P = 0.028) and they had an older age of onset (22.9 ± 8.0 vs 20.7 ± 6.7 years, P = 0.028). Binary logistic regression analysis revealed that presence of uveitis was significantly associated with HLA-B*2705 (P = 0.008; odds ratio, 2.63; 95% confidence interval, 1.283-5.393). There were no significant differences in family history, low back pain, peripheral arthritis, or hip joint involvement among HLA-B27 subtypes. Specific HLA-B27 subtypes were positively associated with particular clinical features of AS. AS patients with HLA-B*2705 demonstrated an older age of onset and had a higher risk of uveitis and dactylitis than did AS patients with HLA-B*2704.

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Section: Discussionmentioning

confidence: 99%

Higher risk of uveitis and dactylitis and older age of onset among ankylosing spondylitis patients with HLA‐B2705* than patients with HLA‐B2704* in the Chinese population

Liao

et al. 2013

Tissue Antigens

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“…AxSpA affects more men than women of any ethnic background, being more frequently found in Northern Europe Caucasians and is rare among Africans (2,14). In Brazil, due to marked ethnic miscegenation, the prevalence of AS in mixed race patients (mulatos) was similar to the prevalence among Caucasians, with HLA-B27 present in African Brazilians at a higher rate than in the studies with Africans (15). HLA-B27 is highly relevant to the susceptibility to develop axial SpA, and this association was described in 1973 (3).…”

Section: Case Reportmentioning

confidence: 78%

Coexistence of spondyloarthritis and joint hypermobility syndrome: rare or unknown association?

Carneiro

Souza

Oliveira³

et al. 2017

Reumatismo

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SUMMARYWe report two cases of siblings presenting coexisting non-radiographic axial spondyloartrhritis and joint hypermobility syndrome, complaining of back pain with morning stiffness, enthesitis, peripheral arthralgia, high erythrocyte sedimentation rate and C-reactive protein level and positive HLA-B27. The association of these two conditions is rare, but especially interesting in view of their contrasting features, one causing axial skeleton stiffness, the other a wider range of peripheral joint movements. Coexistence of these two opposite disorders causes confusion in diagnosis and management, resulting in lower quality of life for patients, as they are in pain from the early stages. Therefore, this association is suspected in young individuals with back pain and physical exam findings of peripheral joint hypermobility and axial skeleton loss of mobility. Key words:Non-radiographic axial spondyloarthritis; Spondyloarthritis; HLA-B27; Hypermobility; Joint hypermobility syndrome. Reumatismo, 2017; 69 (3): 126-130 n INTRODUCTION T he term non-radiographic axial spondyloarthritis (nrAxSpA) was created to designate patients suffering from early stages of ankylosing spondylitis (AS), which is a chronic inflammatory disease that affects the axial skeleton, peripheral joints and extra articular structures, characterized by sacroiliitis, enthesitis, uveitis, psoriasis, structural and functional impairments, causing low quality of life. It affects people younger than 45 years old with a ratio of roughly 2 to 1 in favor of males (1, 2). Strong familiarity of AS over three generations was demonstrated in a study and the molecule HLA B27, first described over 40 years ago, is the most important gene predisposing to axial spondyloarthritis (AxSpA). However, no consensus has been reached to date about the role of HLA B27 (1-3). The joint hypermobility syndrome (JHS) was first described in 1967 by Kirk et al. (4), who defined it as an increased range of movement of one or more joints seen in childhood, and declining in adulthood (5, 6). It is more frequently found in women and more prevalent among people of Asian and African descent, compared to Caucasians (6, 7). Also known as benign joint hypermobility syndrome (BJHS), this condition requires a clinical diagnosis that is carried out according to Brighton criteria, which include generalized joint hypermobility, resulting in recurrent joint dislocation, chronic limb and joint pain and skin involvement (8). Type III EhlersDanlos syndrome (EDS) is characterized by joint hypermobility, lax skin, a hereditary family pattern and may be associated with dysautonomia and fatigue (5). Some authors consider BJHS and EDS as synonyms (8, 9). The coexistence of SpA and JHS is rare, with few reports in the literature, evidencing how difficult diagnosis may be, as these

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“…Many of the studies included in this review used a cross-sectional design, which limits the interpretation of causal relationships in AS. 35,36 It allows the researchers to note associations but denies the ability to sequence events in disease etiology. A Brazilian study juxtaposes epidemiologic variables between two age groups: juvenile (younger than 16 years of age) and adult-onset (greater than 16 years of age) spondyloarthropathy.…”

Section: Discussionmentioning

confidence: 99%

“…Skare et al evaluated 1318 consecutive patients with spondyloarthropathies (SpA), in 29 different referral centers throughout Brazil. 35 They compared and contrasted the disease expressivity and variance of SpA among different ethnic backgrounds. This was achieved through a standard protocol of investigation outlined by the researchers, whereby information was retrieved from patient interviews and multiple self-assessment scores (BASDAI, BASFI, AS quality of life questionnaire etc.).…”

Section: Relevance Of Ethnicitymentioning

confidence: 99%

Establishing a Causal Link between Ankylosing Spondylitis and Inflammatory Bowel Disease: A Review of the Literature

Rivington¹,

Gillett²

2016

Int J Med Students

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The link between ankylosing spondylitis and inflammatory bowel disease is unclear, however it is hypothesized that there is a causal link between the inheritance of a human leukocyte antigen B27 allele and the development of inflammatory bowel disease symptoms in ankylosing spondylitis patients. Research articles assessing the relationship between ankylosing spondylitis, inflammatory bowel disease and the human leukocyte antigen B27 antigen were collected from the PubMed database. Patients expressing the human leukocyte antigen B27 allele have a demonstrated predisposition to developing symptoms of inflammatory bowel disease and sacroiliitis in ankylosing spondylitis. However, human leukocyte antigen B27 is considered to be just a contributing factor in the disease, as interleukin-23, natural killer cells, and alterations to the microbiome have also demonstrated an active role in the development of symptoms. More longitudinal studies using larger cohorts are needed to further substantiate a direct causal relationship between ankylosing spondylitis and inflammatory bowel disease.

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Ethnic Influence in Clinical and Functional Measures of Brazilian Patients with Spondyloarthritis

Abstract: Ethnic background is associated with distinct clinical aspects of SpA in Brazilian patients. African Brazilian patients with SpA have a poorer quality of life and report worse disease compared to whites.

Cited by 24 publications

References 27 publications

Higher risk of uveitis and dactylitis and older age of onset among ankylosing spondylitis patients with HLA‐B2705* than patients with HLA‐B2704* in the Chinese population

Higher risk of uveitis and dactylitis and older age of onset among ankylosing spondylitis patients with HLA‐B2705* than patients with HLA‐B2704* in the Chinese population

Coexistence of spondyloarthritis and joint hypermobility syndrome: rare or unknown association?

Establishing a Causal Link between Ankylosing Spondylitis and Inflammatory Bowel Disease: A Review of the Literature

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Ethnic Influence in Clinical and Functional Measures of Brazilian Patients with Spondyloarthritis

Abstract: Ethnic background is associated with distinct clinical aspects of SpA in Brazilian patients. African Brazilian patients with SpA have a poorer quality of life and report worse disease compared to whites.

Cited by 24 publications

References 27 publications

Higher risk of uveitis and dactylitis and older age of onset among ankylosing spondylitis patients with HLA‐B*2705 than patients with HLA‐B*2704 in the Chinese population

Higher risk of uveitis and dactylitis and older age of onset among ankylosing spondylitis patients with HLA‐B*2705 than patients with HLA‐B*2704 in the Chinese population

Coexistence of spondyloarthritis and joint hypermobility syndrome: rare or unknown association?

Establishing a Causal Link between Ankylosing Spondylitis and Inflammatory Bowel Disease: A Review of the Literature

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Higher risk of uveitis and dactylitis and older age of onset among ankylosing spondylitis patients with HLA‐B2705* than patients with HLA‐B2704* in the Chinese population

Higher risk of uveitis and dactylitis and older age of onset among ankylosing spondylitis patients with HLA‐B2705* than patients with HLA‐B2704* in the Chinese population