Department of Medicine II, Freiburg University Medical Center, University of Freiburg, Freiburg, Germany.
Curr Opin Rheumatol. 2013 Jul;25(4):426-33. doi: 10.1097/BOR.0b013e328362018f.
HLA-B27 is associated with low viral load and long-term nonprogression in HIV infection as well as spontaneous clearance of hepatitis C virus (HCV) infection. This review summarizes mechanisms that have been suggested to be involved in this protective effect of HLA-B27, and highlights possible lessons for the role of HLA-B27 in spondyloarthritis.
Recent studies linked protection by HLA-B27 in HIV and HCV infection to virological mechanisms such as a complicated pathways of viral escape from immunodominant HLA-B27-restricted virus-specific CD8+ T-cell epitopes. In addition, several immunological mechanisms have been proposed, including CD8+ T-cell polyfunctionality and functional avidity, thymic selection of CD8+ T-cell precursors, specific T-cell receptor repertoires and clonotypes, efficient antigen processing, and evasion from regulatory T-cell-mediated suppression.
Multiple virological and immunological mechanisms have been suggested to contribute to HLA-B27-mediated protection in HIV and HCV infection. Some of these mechanisms may also be involved in HLA-B27-associated pathogenesis in spondyloarthritis.
HLA-B27 与 HIV 感染中的低病毒载量和长期无进展以及丙型肝炎病毒 (HCV) 感染的自发性清除有关。本综述总结了被认为与 HLA-B27 这种保护作用相关的机制，并强调了 HLA-B27 在脊柱关节炎中作用的可能意义。
最近的研究将 HLA-B27 在 HIV 和 HCV 感染中的保护作用与病毒学机制联系起来，例如病毒从免疫显性 HLA-B27 限制的病毒特异性 CD8+ T 细胞表位逃逸的复杂途径。此外，还提出了几种免疫机制，包括 CD8+ T 细胞的多功能性和功能亲和力、CD8+ T 细胞前体的胸腺选择、特异性 T 细胞受体库和克隆型、有效的抗原加工以及逃避调节性 T 细胞介导的抑制。
多种病毒学和免疫学机制被认为有助于 HIV 和 HCV 感染中 HLA-B27 介导的保护作用。其中一些机制也可能与 HLA-B27 相关的脊柱关节炎发病机制有关。
