HL‐A 27 in reactive arthritis. A study of yersinia arthritis and Reiter's disease

Abstract

The histocompatibility antigen HL‐A 27 was identified in 43 of 49 patients with yersinia arthritis and in 36 of 40 patients with Reiter's disease, compared with 3 of 20 patients with yersinia infection without arthritis and 14% of the normal Finnish population. HL‐A 2 occurred in patients with reactive arthritis in the same high frequency as did HL‐A 27, but this antigen is present in 55% of Finns. HL‐A 27 negative patients usually had a mild or somewhat atypical disease.

Chemotaxis in yersinia arthritis HLA‐B27 positive neutrophils show high stimulated motility in vitro

“…One biologic implication of the finding in the present study is that the high responder HLA-B27 positive PMNs may contribute to a more prolonged disease (8,9), and to the occurrence of extraarticular inflammatory manifestations such as carditis and ocular symptoms (7,9, Table l), which are more common in yersinia arthritis patients with HLA-B27 than in those without Mowat (21) reported normal chemotaxis in ankylosing spondylitis and in acute Reiter's disease, both of which are known to be strongly associated with HLA-B27 (6). There are several explanations for the discrepancy between his results and ours.…”

“…HLA-B27 positive patients with reactive arthritis have a more prolonged disease (8,9) with more frequent extraarticular inflammatory manifestations (7,9) than do HLA-B27 negative patients. Polymorphonuclear leukocytes (PMNs) play an essential role in the inflammatory response by migrating to the site of tissue injury, ingesting foreign particles and damaged tissue components, and releasing lysosomal enzymes, thereby accelerating the inflammation.…”

High prevalence of hla‐cw1 and cw2 antigens in spondylarthritis

“…The high frequency of idiopathic ankylosing spondylitis and Reiter's syndrome in these HLA-B27 patients (81%) was not unexpected since this association has been extensively documented (1,2,(4)(5)(6)(7)(8)(9)(10)(11)(12). Recent studies have emphasized the clinical diversity of these and related spondylarthritic syndromes and the potential importance of HLA typing in the diagnosis of early, ill defined, or atypical seronegative arthritides (25-29).…”

“…The high prevalence of transplantation antigen HLA-B27 in spondylarthritis is well established (1)(2)(3)(4)(5)(6)(7)(8)(9). This association is particularly strong in idiopathic ankylosing spondylitis and Reiter's syndrome where B27 is present in 88-96% (1, 2) and 63-96% (4-9) of cases, respectively.…”

“…This association is particularly strong in idiopathic ankylosing spondylitis and Reiter's syndrome where B27 is present in 88-96% (1, 2) and 63-96% (4-9) of cases, respectively. Juvenile rheumatoid arthritis and other diseases with spondylitic features such as psoriasis, inflammatory bowel disease, Yersinia enterocolitis, and acute anterior uveitis also have an increased prevalence of B27, ranging from 41-91% (3,4,6). Even more striking is the discovery of clinical and/or radiographic changes of spondylitis in 18-25% of unselected and apparently normal B27 individuals (10)(11)(12).…”