REVIEW - HLA-B27 - what's new?

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Rheumatology Advance Access published online on January 18, 2010

Rheumatology, doi:10.1093/rheumatology/kep450

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Review

HLA-B27: what’s new?

J. Sheehan1

1Department of Rheumatology, borough and Stamford Hospitals NHS

Foundation Trust, borough, UK.

Abstract

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.

http://rheumatology.oxfordjournals.org/cgi/content/abstract/kep450v1?papetoc

Not an MD