Rheumatology Department, Norfolk & Norwich University Hospital, Norwich, UK.
Rheumatology Department, Royal National Hospital for Rheumatic Diseases, Bath, UK.
Rheumatology (Oxford). 2018 Jun 1;57(6):959-968. doi: 10.1093/rheumatology/kex345.
The association between HLA-B27 and AS was first established in the early 1970s. Since then, our understanding of this disease has changed, such that we now recognize AS to be the extreme of the clinical phenotype within a disease spectrum known as axial SpA (axSpA). Recent advances in therapeutic options have driven the need for earlier diagnosis and many screening strategies have been proposed to facilitate this. In parallel, our understanding of axSpA genetics, and especially the contribution of HLA-B27, has expanded. In this article we will present and discuss the evidence supporting the use of HLA-B27 in clinical practice. We will briefly summarize the evolution of the concept of axSpA, the prevalence of HLA-B27 and axSpA and the potential role of HLA-B27 in the aetiopathogenesis of axSpA and focus on the utility of HLA-B27 in everyday clinical practice.
HLA-B27 与 AS 的关联最早于 20 世纪 70 年代确立。从那时起，我们对这种疾病的认识发生了变化，现在我们认识到 AS 是一种称为中轴型脊柱关节炎（axSpA）疾病谱中临床表型的极端情况。治疗选择的最新进展推动了更早诊断的需求，为此提出了许多筛选策略。与此同时，我们对 axSpA 遗传学的认识，特别是 HLA-B27 的作用，也得到了扩展。在本文中，我们将介绍和讨论支持 HLA-B27 在临床实践中应用的证据。我们将简要总结 axSpA 概念的演变、HLA-B27 和 axSpA 的流行情况以及 HLA-B27 在 axSpA 发病机制中的潜在作用，并重点介绍 HLA-B27 在日常临床实践中的应用。
