Low frequency of HLA-B27 in ankylosing spondylitis and its relationship with clinical findings in patients from Turkey

Kang

et al. 2021

Preprint

The aim of this study was to investigate the potential correlation between the human leukocyte antigen (HLA)-B*27 subtypes in patients with ankylosing spondylitis (AS) and the clinical features of AS. The prevalence of HLA-B*27 subtypes was investigated in 132 healthy donors recruited from our center and in 143 patients with AS. We investigated the differences in HLA-B27 subtype status for the patients and healthy donors by using a PCR-SSP (polymerase chain reaction with sequence-specific primer) method. The clinical outcomes of the patients, including lower back pain, uveitis, peripheral arthritis, stiffness, joints, erythrocyte sedimentation rate (ESR), Anti-streptolysin O (ASO) and C-reactive protein (CRP), were recorded. The male-to-female ratio was 2.5, and the mean age at diagnosis was 29.3 years. HLA-B*27 positivity was detected in 111 patients (77.6%) of patients with AS. The rate of HLA-B*27 positivity was significantly higher in the AS group than patients without AS. The subtypes observed in patients with AS were HLA-B*2704 (55.9%, 62/111), HLA-B*2705 (39.6%, 44/111), HLA-B*2702 (1.80%, 2/111), HLA-B*2707 (0.90%, 1/111), and HLA-B*2704/05(1.80%, 2/111). The main genotypes were HLA-B*2704 and HLA-B*2705. There were no significant differences in clinical manifestations. Multivariate analysis showed statistically significant differences in sex (P=0.01), disease duration (P=0.023), hematocrit (P=0.01), and CRP (P=0.01) between patients in the HLA-B*27(+) AS group and the HLA-B*27(-) AS group. In addition, HLA-B*15, HLA-B*40, HLA-B*13, and HLA-B*46 were the major alleles with associated HLA-B types in patients with HLA-B*27(+) AS. Therefore, we conclude that HLA-B*27 is highly correlated with AS and can be used as an early predictor of AS. In addition, sex, disease duration, ESR, and CRP were significantly different in the HLA-B*27(+) AS group and HLA-B*27(-) AS group. Finally, our study also found a correlation between HLA-B*15, HLA-B*40, HLA-B*13, and HLA-B*46 subtypes and the development of AS.

Section: Allele With Thesupporting

confidence: 93%

Analysis of Gene Expression of Human Leukocyte Antigen B27 in Patients with Ankylosing Spondylitis and Correlation with Related Indicators

Kang

et al. 2021

Preprint

Current Opinion in Rheumatology

“…The HLA-B27 association may also be weaker in southern than northern Europe. For example, a recent study from Turkey [9] indicates that the frequency of HLA-B27 among AS cases is only 70% compared with 85% in our UK sample of 8,500 cases. This study confirmed earlier reports of a somewhat weaker association with AS in Turkey where there is also a lower HLA-B27 frequency (2.6%) in the general population [10].…”

Section: Hla-b27 and As/axspacontrasting

confidence: 63%

Quantifying the genetic risk for the development of axial spondyloarthropathy: could this become a diagnostic tool?

Wordsworth

Cohen

Vecellio

2018

“…Conversely, arthritis, enthesitis, and relevant family history had no association with HLA-B27, which differed from the Chung et al study 8 . These characteristics were not found to significantly associate with HLA-B27 in studies conducted in Turkey 32 and Lebanon 28 . This may be due to different duration of disease, ethnicity, and/or genetics, including HLA-B27 subtype.…”

Section: Discussionmentioning

confidence: 67%

Younger age of onset and uveitis associated with HLA-B27 and delayed diagnosis in Thai patients with axial spondyloarthritis

Limsakul

Chiowchanwisawakit

Permpikul

et al. 2021

Sci Rep

To identify characteristics associated with HLA-B27, and to identify factors associated with delayed diagnosis in Thai patients with axial spondyloarthritis (axSpA). This cross-sectional study included Thai patients were diagnosed with axSpA by a rheumatologist at Siriraj Hospital. Clinical data were collected. Regression analyses were employed to identify factors associated with study outcomes. Of total 177 patients, 127 (72%) were positive HLA-B27. Uveitis [Odds ratio (OR) 4.0], age at onset of the first musculoskeletal symptom of ≤ 28 years [OR 3.5], female [OR 0.4], and psoriasis [OR 0.4] were significantly associated with HLA-B27 in multiple regression analysis. Those with positive HLA-B27 had less spinal flexibility. Elevated C-reactive protein (p = 0.012) was associated with shorter delay in diagnosis, while uveitis (p < 0.001) and younger age at onset of the first symptom (p = 0.002) were associated with longer delay in diagnosis in multiple regression analysis. Younger age at onset of the first musculoskeletal symptom and uveitis were associated with HLA-B27 and delayed diagnosis in axSpA patients. Young people with musculoskeletal symptom and uveitis should be referred to a rheumatologist to rule out or make a timely diagnosis of axSpA.