Meneses-Toro Maria Alejandra, Calixto Omar Javier, Parra-Izquierdo Viviana, Flórez-Sarmiento Cristian, de-Quiroga Juliette de Ávila, Ramos-Casallas Alejandro, Chila-Moreno Lorena, Bello-Gualtero Juan Manuel, Bautista-Molano Wilson, Romero-Sanchez Consuelo
Hospital Militar Central, Rheumatology and Immunology Department, Clinical Immunology Group, Bogotá, Colombia.
Universidad Militar Nueva Granada, School of Medicine, Clinical Immunology Group, Bogotá, Colombia.
Rev Alerg Mex. 2024 Feb 1;71(1):66. doi: 10.29262/ram.v71i1.1371.
This study aimed to establish the association between HLA-A, B, DR genotypes and gastrointestinal variables in patients with SpA without inflammatory bowel disease (IBD).
Retrospective study of 91 patients with SpA and 401 healthy controls, with typing by Illumina Sequencing/PacBio and LIFECODES HLA-PCR/SSO multiplex sequencing technology. The presence of gastrointestinal symptoms was evaluated by administering a survey, and those who presented 2 or more symptoms were taken for clinical evaluation by rheumatology and gastroenterology, colonoscopy and histopathological study. (Ethics committee approval).
The 59,3% of the patients were men, with a mean age of 43,9±11.4 years; 80,2% were classified as ankylosing spondylitis. 14, 28 and 19 genotypes for the HLA-A*, HLA-B* and HLA-DR* loci were identified in both groups, of which a relationship with gastrointestinal symptoms was identified: and were associated to abdominal pain, and with abdominal distention, and with weight loss, with diarrhea >4 weeks, and presence of mucus in the stools with and (p<0.05). Furthermore, the presence of had a statistical relationship with intolerance to some food, highlighting the genotype in relation to grains and dairy products, with grains, vegetables and meats, and with vegetables and dairy (p<0.05). Regarding the endoscopic variables, macroscopic changes were found in the ileum mucosa related to and the relationship between and ulcers at this level should be highlighted. Macroscopic changes in the sigmoid colon with and the rectum with . In microscopic changes, inflammatory alterations of the ileum are mentioned with genotypes and , a genotype that is related to changes in the ileum both endoscopically and histologically (p<0.05).
These findings indicate a potential genetic predisposition related to HLA genotypes that may increase the likelihood of food intolerance, gastrointestinal symptoms, and even visible and microscopic changes, specifically in the ileal tissue. The study highlights the presence of B27 and other noteworthy HLA class I and class II genes (such as DRB114) in the diverse Colombian population.
