engleski

THE INFLUENCE OF HLA-B27 IN PREDISPOSITION TO SPONDYLOARTHROPATIES AMONG EASTERN CROATIANS

The seronegative spondyloarthropathies (SpA) are a diverse family of chronic rheumatoid disorders characterized by rheumatoid factor autoantibody negative serum, joint inflammation and extra-articular manifestations including psoriasis, uveitis and inflamatory bowel disease. The clinical subsets of SpA include ankylosing spondylitis (AS), reactive arthritis (ReA), psoriatic arthritis (PsA), entheropathic arthritis (EA) and undifferentiated SpA (UdSpA). Human leukocyte antigen-B27 (HLA-B27) gene is the most commonly accounted HLA locus in the genetic background of SpA. However, its overall genetic contribution to disease susceptibility varies between the SpA subsets as well as between ethnic groups and populations. In order to determine HLA-B27- associated risk for SpA in Eastern Croatian population, patients with AS (n=7), PsA (n=15), ReA (n=23), UdSpA (n=27) and rheumatoid arthritis (n=16) were typed for HLA-B27 locus using sequence-specific primer PCR methodology (SSP-PCR). Antigen frequency was compared to data obtained from previously typed, unrelated, healthy Croatian controls (n=210) by using Fisher exact test and odds ratio. The frequency of HLA-B27 antigen was significantly associated with the risk for UdSpA [25.9% in patients vs. 10.0% in controls, P=0.025 OR=3.15, 95% confidence interval (1.06-9.1)], and particularly with AS susceptibility [71, 4% vs. 10%, P=0.0003 OR=22.5 95% CI (3.53-180.4)]. No significant association was revealed between B27 and other tested SpA clinical subsets, or RA. These observations suggest an important role for B27 in genetic risk assessment for UdSpA forms and AS development in our population. However, the occurrence of PsA, ReA and RA appears to be under the influence of non-B27 predisposing factors, both within and outside of the major histocompatibility complex. Sample size enlargement and HLA class I loci typing are necessary for determining form-specific SpA genetic variants.

HLA-B27; spondyloarthropaties; Eastern Croatia

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