Analysis of HLA-B15 and HLA-B27 in spondyloarthritis with peripheral and axial clinical patterns
Analysis of HLA-B15 and HLA-B27 in spondyloarthritis with peripheral and axial clinical patterns
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DOI：
10.1136/bmjopen-2015-009092
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发表时间：
2015-01-01
期刊：
影响因子：
2.9
通讯作者：
Medina, Juan F.
中科院分区：
文献类型：
--
作者：
Londono, John;Maria Santos, Ana;Medina, Juan F.
目的：人白细胞抗原（HLA） B27和HLA- b15与脊柱炎（SpA）相关。最近的国际协会评估脊椎关节炎（ASAS）标准强调了轴型和外周型SpA的区别。我们分析了HLA-A、HLA-B和HLA-DRB1等位基因是否与这些模式相关。方法：按照欧洲脊椎关节病研究组（European Spondyloarthropathy Study Group， ESSG）的标准，对100名健康个体和178名SpA患者进行研究。然后根据ASAS标准对患者进行分类，轴性脊柱炎类型（axSpA）由确定的骶髂炎定义，外周型（pSpA）由四肢炎和/或关节炎定义。还考虑了组合的ax/p模式。结果：仅有HLA-B27和HLA-B15等位基因与SpA相关。152例患者符合ASAS的axSpA标准（12例为单独axSpA， 140例为ax/p合并模式）。当应用ASAS外周标准时，161例患者符合这些标准（13例单独pSpA， 148例合并ax/p模式）。根据axASAS， HLA-B27在83%的axSpA患者和43%的ax/pSpA患者中被发现。HLA-B27出现在7%的对照组中，但没有出现在任何孤立性pSpA患者中。根据pASAS标准，31%的孤立性pSpA患者和20%的ax/pSpA患者存在HLA-B15。此外，2名健康对照，但我们分离的axSpA患者均未出现HLA-B15阳性。结论：我们的数据表明，HLA-B15的存在有利于孤立/联合外周而不是孤立的axSpA的发展，而HLA-B27促进孤立/联合轴向疾病，排除外周模式。根据ASAS标准诊断SpA患者时，除考虑HLA-B27外，还应考虑HLA-B15。
Objective: Human leucocyte antigen (HLA) B27 and HLA-B15 are associated with spondyloarthritis (SpA). Recent Assessment of SpondyloArthritis international Society (ASAS) criteria emphasise a distinction between SpA with axial and peripheral patterns. We analysed whether HLA-A, HLA-B and HLA-DRB1 alleles could associate with these patterns.Methods: We studied 100 healthy individuals and 178 patients with SpA according to European Spondyloarthropathy Study Group (ESSG) criteria. Patients were then classified according to ASAS criteria, the axial spondyloarthritis pattern (axSpA) being defined by ascertained sacroiliitis and the peripheral pattern (pSpA) by enthesitis and/or arthritis in extremities. A combined ax/p pattern was also considered.Results: Only HLA-B27 and HLA-B15 alleles were associated with SpA. ASAS criteria for axSpA were met in 152 patients (12 with isolated axSpA and 140 with a combined ax/p patterns). When the ASAS peripheral criteria were applied, 161 patients met these criteria (13 with isolated pSpA and 148 with a combined ax/p pattern). HLA-B27 was found in 83% of patients with axSpA and 43% of ax/pSpA patients according to axASAS. HLA-B27 occurred in 7% controls but not in any patient with isolated pSpA. HLA-B15 was encountered in 31% of patients with isolated pSpA and 20% of ax/pSpA patients according to pASAS criteria. Moreover, 2 healthy controls, but none of our patients with isolated axSpA were positive for HLA-B15.Conclusions: Our data suggest that the presence of HLA-B15 favours the development of isolated/combined peripheral rather than isolated axSpA, while HLA-B27 promotes an isolated/combined axial disease and excludes a peripheral pattern. HLA-B15 should be considered in addition to HLA-B27 when diagnosing patients with SpA according to ASAS criteria.