Department of Rheumatology, City Care Centre, Thorpe Road, Peterborough PE3 6DB, UK.
Rheumatology (Oxford). 2010 Apr;49(4):621-31. doi: 10.1093/rheumatology/kep450. Epub 2010 Jan 18.
The HLA-B27 molecule is one of the most fascinating in medicine. Its contribution to the aetiopathogenesis of SpA and other diseases, and its protective action in certain infections, continue to challenge our understanding of its immunobiology and physiological roles. Animal studies have helped to cast light on ways in which HLA-B27 exerts its effects. Subtle variations in structure and behaviour between B27 subtypes that are strongly associated with SpA, compared with those whose association is neutral or weak, are helping to elucidate its pathogenetic mechanisms. However, none of the current hypotheses fully explains the observed actions of HLA-B27. Consequently, attention is turning to how haplotype linkages and genetic networks involving other MHC and non-MHC genes influence the penetrance and clinical expression of B27. HLA-B27 gives an intriguing insight into the connection between heredity and disease. As well as its close links with SpA, various other associations have been reported between B27 and diseases of different organs and systems. Evidence is also accumulating that it mitigates the virulence of HIV and other viral infections. The role of HLA-B27 as an aid to diagnosis, prognosis and disease management is gradually becoming clearer.
HLA-B27 分子是医学中最引人入胜的分子之一。它在 SpA 和其他疾病的发病机制中的作用，以及在某些感染中的保护作用，不断挑战着我们对其免疫生物学和生理作用的理解。动物研究有助于揭示 HLA-B27 发挥作用的方式。与与 SpA 相关的强烈相关的 B27 亚型相比，结构和行为上的细微差异，以及那些与其关联为中性或较弱的 B27 亚型，正在帮助阐明其发病机制。然而，目前没有任何假设能够完全解释 HLA-B27 的观察到的作用。因此，人们的注意力转向涉及其他 MHC 和非 MHC 基因的单倍型连锁和遗传网络如何影响 B27 的外显率和临床表达。HLA-B27 为遗传与疾病之间的联系提供了一个有趣的视角。除了与 SpA 密切相关外，还报道了 B27 与不同器官和系统的疾病之间的各种其他关联。证据还在不断积累，表明它可以减轻 HIV 和其他病毒感染的毒力。HLA-B27 在诊断、预后和疾病管理中的作用逐渐变得更加清晰。
