Paediatric Rheumatology
HLA-B27 subtypes in enthesitis-related arthritis category of juvenile idiopathic arthritis and ankylosing spondylitis in northern India
R. Srivastava1, S. Agnihotry2, R. Aggarwal3, P. Bajpai4, A. Aggarwal5
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, and Department of Biosciences, Integral University, Lucknow, India.
- Biomedical Informatic Centre, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
- Department of Biosciences, Integral University, Lucknow, India.
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India. amita@sgpgi.ac.in
CER8224
2015 Vol.33, N°6
PI 0931, PF 0935
Paediatric Rheumatology
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PMID: 26314893 [PubMed]
Received: 22/12/2014
Accepted : 21/04/2015
In Press: 27/08/2015
Published: 15/12/2015
Abstract
OBJECTIVES:
Enthesitis-related arthritis (ERA) is the most common form of juvenile idiopathic arthritis (JIA) in the Asian and Indian populations. The presence of HLA-B27 has a strong association with JIA-ERA similar to that with adult ankylosing spondylitis (AS). The HLA-B27gene is highly polymorphic. Susceptibility to AS varies between different HLA-B27 subtypes; data on the relationship of susceptibility to JIA-ERA with HLA-B27 types are scant. In this study, we determined HLA-B27 subtypes in patients with JIA-ERA and AS to find out whether there is any difference in the HLA-B27 subtypes prevalent in these two diseases.
METHODS:
Genomic DNA from 135 patients with JIA-ERA and 121 with AS was tested for the presence of HLA-B27. In patients testing positive, HLA-B27subtyping was done by sequencing a genomic region that contained second and third exons and the intervening intron of this gene; this method permitted identification of common HLA-B27 subtypes (HLA-B*27:01 to HLA-B*27:09).
RESULTS:
One hundred and seven (79%) patients with JIA-ERA and 102 (84%) patients with AS tested positive for HLA-B27. In both groups, HLA-B*27:05 and HLA-B*27:04 were the common subtypes; some patients had HLA-B*27:07(7.4%) and HLA-B*27:18. Patients with JIA-ERA had a higher frequency of HLA-B*27:05 than those with AS (70% vs. 57%, p=0.047), and a lower frequency of HLA-B*27:04 (21% vs. 36%, p=0.018).
CONCLUSIONS:
HLA-B*27:05 and HLA-B*27:04 were the most common HLA-27 subtypes in both JIA-ERA and AS. However, HLA-B*27:05 was more frequent and HLA-B*27:04 was less frequent in JIA-ERA. It is possible that HLA-B*27:05 being the ancestral HLA-27 subtype leads to expression of disease early in life.