Mishra Mahandra Narain, Singal Vinay
Department of Pathology, Command Hospital (SC), Pune, India.
Iran J Immunol. 2010 Dec;7(4):252-6.
Spondyloarthropathies are a group of closely related inflammatory arthritis which involve the axial skeleton and are negative for rheumatoid factor.
This case-control study was conducted to examine HLA- B27 positivity in patients with seronegative spondyloarthritis (SSA) as per ESSG criteria and compare the frequency with healthy controls because a lower positivity is reported in Indians.
The study included 453 patients and 200 controls. HLA -B27 typing was done by microlymphocytotoxicity and/or by sequence specific primers (SSP) using commercial kits. Patients were categorised as Ankylosing Spondylitis (AS), Undifferentiated Spondyloarthropathy, SSA with inflammatory bowel disease, reactive arthritis, psoriatic arthritis and juvenile spondyloarthropathy.
HLA- B27 antigen was present in 56% of patient and 3.5% controls with highest frequency in juvenile spondyloarthropathy (80%), followed by AS (76%). The P value < 0.001 for all categories of SSA and overall Odds ratio was 34.9.
This study showed HLA-B27 frequency slightly lower than reported in Caucasian SSA patients and in our opinion HLA- B27 testing is extremely useful in young patients with suspected SSA.
脊柱关节病是一组密切相关的炎性关节炎，累及中轴骨骼，类风湿因子阴性。
进行这项病例对照研究，以根据欧洲脊柱关节病研究组（ESSG）标准检测血清阴性脊柱关节炎（SSA）患者的HLA - B27阳性情况，并与健康对照进行频率比较，因为据报道印度人的阳性率较低。
该研究纳入了453例患者和200例对照。使用商业试剂盒通过微量淋巴细胞毒性和/或序列特异性引物（SSP）进行HLA - B27分型。患者被分类为强直性脊柱炎（AS）、未分化脊柱关节病、伴有炎性肠病的SSA、反应性关节炎、银屑病关节炎和青少年脊柱关节病。
56%的患者存在HLA - B27抗原，而对照组为3.5%，青少年脊柱关节病的频率最高（80%），其次是AS（76%）。所有类型的SSA的P值<0.001，总体优势比为34.9。
本研究显示HLA - B27频率略低于白种人SSA患者的报道频率，我们认为HLA - B27检测对疑似SSA的年轻患者极为有用。
