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Peña JRA, Fung MK, Gandhi MJ. A Review of Laboratory Practices Using the HLA-B27 Survey by the College of American Pathologists: How Important Is Allele-Level Typing? Arch Pathol Lab Med 2024; 148:149-154. [PMID: 37134231 DOI: 10.5858/arpa.2022-0322-cp] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2023] [Indexed: 05/05/2023]
Abstract
CONTEXT.— Ankylosing spondylitis (AS) is an autoimmune disorder with a strong genetic risk, especially with HLA-B27. Clinical testing for HLA-B27 has been used to help diagnose patients with signs and symptoms of AS. Testing methods used by clinical laboratories for HLA-B27 fall into the broad categories of serologic/antibody- or molecular-based methods and have evolved over time. The College of American Pathologists (CAP) offers a proficiency testing survey for HLA-B27. OBJECTIVE.— To analyze HLA-B27 testing trends and their performance in the past decade, using the proficiency testing survey data submitted to CAP. DESIGN.— We analyzed the HLA-B27 CAP proficiency testing data from 2010 to 2020 for the method used, participant concordance, and error rates. Results from case scenarios to understand evolving scientific data around HLA-B27 risk alleles were also analyzed. RESULTS.— Antibody-based flow cytometry is the most common method, though it has decreased from 60% in 2010 to 52% in 2020, with a corresponding increase in molecular methods. Among the molecular methods, real-time polymerase chain reaction has increased from 2% to 15%. Flow cytometry had the highest error rate (5.33%), and sequence-specific oligonucleotide (0%) is the most accurate (0%). Results of case scenarios demonstrated that most participants understood that allele-level HLA-B27 typing results inform clinical interpretation, for example HLA-B*27:06 is not associated with AS. CONCLUSIONS.— These data demonstrated the changing trends for HLA-B27 testing during the past decade. HLA-B27 allelic typing provides a better understanding of AS association. This is possible by testing for the second field with methods like next-generation sequencing.
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Affiliation(s)
- Jeremy Ryan Andrew Peña
- From the Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts (Peña)
| | - Mark K Fung
- the Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, Burlington (Fung)
| | - Manish J Gandhi
- the Division of Transfusion Medicine, Mayo Clinic, Rochester, Minnesota (Gandhi)
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Zhang S, Peng L, Li Q, Zhao J, Xu D, Zhao J, Wang Q, Li M, Zhang W, Tian X, Su J, Zeng X. Spectrum of Spondyloarthritis Among Chinese Populations. Curr Rheumatol Rep 2022; 24:247-258. [PMID: 35829981 PMCID: PMC9307523 DOI: 10.1007/s11926-022-01079-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2022] [Indexed: 11/26/2022]
Abstract
Purpose of Review This review aims to emphasize interesting and important new findings with a focus on the spectrum of spondyloarthritis (SpA) in China. Recent Findings Over the past decade, significant advances have been made in the investigation of SpA epidemiology, the exploration of genetic and environmental risk factors, the identification of clinical features, and the updating of treatment protocols in the Chinese population. The prevalence of ankylosing spondylitis (AS) in China is 0.20–0.42%, and the prevalence of HLA-B27 in AS patients is 88.8–89.4%. HLA-B*2704 is the most common subtype in Chinese AS patients, followed by HLA-B*2705. HLA-A*01, more precisely HLA-A*01:01, may be associated with psoriatic arthritis (PsA). Tumor necrosis factor inhibitors and IL-17A inhibitors have been shown to be effective and safe for AS patients in China. Juvenile-onset AS is relatively rare, accounting for only 9.1% of the AS population. The prevalence of arthritis related to inflammatory bowel disease is 6.9 to 7.2%. A Chinese study showed that the most frequently prescribed medication was methotrexate (66.4%). Biological agents were prescribed in only16.4% of patients with PsA. Summary This review summarizes the latest research in the epidemiology, pathogenesis, clinical manifestations, and management of SpA among Chinese populations. Multiple HLA associations with SpA have also been described, and it is hoped that discoveries of such ethnic-specific risk factor(s) and understanding of their pathological mechanisms may potentially lead to newer targeted therapies for the Chinese populations worldwide.
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Affiliation(s)
- Shangzhu Zhang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH); Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education,, No.1 Shuaifuyuan, Dongcheng district, 100730, Beijing, China
| | - Linyi Peng
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH); Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education,, No.1 Shuaifuyuan, Dongcheng district, 100730, Beijing, China
| | - Qingyang Li
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH); Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education,, No.1 Shuaifuyuan, Dongcheng district, 100730, Beijing, China
| | - Jinwei Zhao
- National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, 300191, Tianjin, China
| | - Dong Xu
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH); Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education,, No.1 Shuaifuyuan, Dongcheng district, 100730, Beijing, China
| | - Jiuliang Zhao
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH); Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education,, No.1 Shuaifuyuan, Dongcheng district, 100730, Beijing, China
| | - Qian Wang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH); Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education,, No.1 Shuaifuyuan, Dongcheng district, 100730, Beijing, China
| | - Mengtao Li
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH); Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education,, No.1 Shuaifuyuan, Dongcheng district, 100730, Beijing, China
| | - Wen Zhang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH); Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education,, No.1 Shuaifuyuan, Dongcheng district, 100730, Beijing, China
| | - Xinping Tian
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH); Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education,, No.1 Shuaifuyuan, Dongcheng district, 100730, Beijing, China
| | - Jinmei Su
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH); Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education,, No.1 Shuaifuyuan, Dongcheng district, 100730, Beijing, China.
| | - Xiaofeng Zeng
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH); Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education,, No.1 Shuaifuyuan, Dongcheng district, 100730, Beijing, China.
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Tanigawa Y, Qian J, Venkataraman G, Justesen JM, Li R, Tibshirani R, Hastie T, Rivas MA. Significant sparse polygenic risk scores across 813 traits in UK Biobank. PLoS Genet 2022; 18:e1010105. [PMID: 35324888 PMCID: PMC8946745 DOI: 10.1371/journal.pgen.1010105] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 02/15/2022] [Indexed: 01/05/2023] Open
Abstract
We present a systematic assessment of polygenic risk score (PRS) prediction across more than 1,500 traits using genetic and phenotype data in the UK Biobank. We report 813 sparse PRS models with significant (p < 2.5 x 10-5) incremental predictive performance when compared against the covariate-only model that considers age, sex, types of genotyping arrays, and the principal component loadings of genotypes. We report a significant correlation between the number of genetic variants selected in the sparse PRS model and the incremental predictive performance (Spearman's ⍴ = 0.61, p = 2.2 x 10-59 for quantitative traits, ⍴ = 0.21, p = 9.6 x 10-4 for binary traits). The sparse PRS model trained on European individuals showed limited transferability when evaluated on non-European individuals in the UK Biobank. We provide the PRS model weights on the Global Biobank Engine (https://biobankengine.stanford.edu/prs).
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Affiliation(s)
- Yosuke Tanigawa
- Department of Biomedical Data Science, Stanford University, Stanford, California, United States of America
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
| | - Junyang Qian
- Department of Statistics, Stanford University, Stanford, California, United States of America
| | - Guhan Venkataraman
- Department of Biomedical Data Science, Stanford University, Stanford, California, United States of America
| | - Johanne Marie Justesen
- Department of Biomedical Data Science, Stanford University, Stanford, California, United States of America
| | - Ruilin Li
- Institute for Computational and Mathematical Engineering, Stanford University, Stanford, California, United States of America
| | - Robert Tibshirani
- Department of Biomedical Data Science, Stanford University, Stanford, California, United States of America
- Department of Statistics, Stanford University, Stanford, California, United States of America
| | - Trevor Hastie
- Department of Biomedical Data Science, Stanford University, Stanford, California, United States of America
- Department of Statistics, Stanford University, Stanford, California, United States of America
| | - Manuel A. Rivas
- Department of Biomedical Data Science, Stanford University, Stanford, California, United States of America
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Fallahi S. Are the earlier disease onset and uveitis affected by the HLA-B*27 subtypes in ankylosing spondylitis? Comments on the article by Silmani et al. Clin Rheumatol 2021; 40:2513. [PMID: 33763800 DOI: 10.1007/s10067-021-05685-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 02/28/2021] [Accepted: 03/05/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Sasan Fallahi
- Internal Medicine Division, Baharloo Hospital, Tehran University of Medical Sciences, Behdari street, South Kargar Street, Tehran, Iran. .,Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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Kumar S, Doss RSA, Rebekah G, Mathews NS, Danda D, Mathew J, Daniel D. Prevalence of HLA-B*27 subtypes in the Tamil population of India with Ankylosing spondylitis and its correlation with clinical features. Hum Immunol 2021; 82:404-408. [PMID: 33773810 DOI: 10.1016/j.humimm.2021.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 01/08/2021] [Accepted: 03/05/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION HLA-B*27 is strongly associated with Ankylosing spondylitis (AS). Its subtypes show considerable geographic and ethnic difference. The main aim of this study was to assess the frequency of subtypes of HLA-B*27 in the Indian Tamil AS patients. METHODS AND MATERIALS Adult AS patients positive for HLA-B*27 were considered for the study. The high-resolution typing to define HLA-B*27 subtypes were done using Invitrogen B kits from One Lambda (SeCore® Sequencing Kits, Thermo Fisher, United States). RESULTS AND CONCLUSION Prevalence of subtypes identified were HLA-B*27:04 (52.2%), HLA-B*27:05 (41.6%), HLA-B*27:07 (3.5%) and HLA-B*27:02 (2.7%). All subtypes showed disease predisposition for males. The most common extra articular manifestation seen was enthesitis in HLA-B*27:04 and HLA-B*27:05. Uveitis was mainly associated with HLA-B*27:05 and dactylitis with HLA-B*27:04. A significant peripheral joints involvement for female and axial joint involvement for males was seen in HLA-B*27:04. Our study establishes the prevalence of HLA-B*27 subtypes and the associated clinical phenotypes among the Indian Tamil population. Considering the variability of presentation, organ involvement, and disease course in different subtypes and across ethnicities it is critical to define these associations in the ethnic populations we treat for their appropriate care considering the significant negative health and socioeconomic effects of AS.
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Affiliation(s)
- Snehil Kumar
- Department of Transfusion Medicine and Immunohaematology, Christian Medical College, Vellore, India.
| | - R Sam Arul Doss
- Department of Transfusion Medicine and Immunohaematology, Christian Medical College, Vellore, India
| | - Grace Rebekah
- Department of Biostatistics, Christian Medical College, Vellore, India
| | - Nitty S Mathews
- Department of Transfusion Medicine and Immunohaematology, Christian Medical College, Vellore, India
| | - Debashish Danda
- Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India
| | - John Mathew
- Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India
| | - Dolly Daniel
- Department of Transfusion Medicine and Immunohaematology, Christian Medical College, Vellore, India
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6
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Spondyloarthritis in North Africa: an update. Clin Rheumatol 2021; 40:3401-3410. [PMID: 33559776 DOI: 10.1007/s10067-021-05630-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 12/06/2020] [Accepted: 02/02/2021] [Indexed: 01/17/2023]
Abstract
Spondyloarthritis (SpA) has been less well studied than rheumatoid arthritis in North Africa, due to a belief that it is rare and benign in certain populations. The main genetic trait of SpA is its association with human leukocyte antigen (HLA)-B27. The distribution of this allele largely explains the prevalence and severity of SpA. The prevalence of HLA-B27 in the general population of North Africa is estimated at about 4%, and rises to about 60% among people affected with SpA. Coxitis is one of the main features of North African SpA, but the response to treatment is comparable to the literature from the West. The major challenge in North Africa remains accessibility to specialized care and means of early diagnosis. Prevalent infections in North Africa do not seem to be a major obstacle to optimal treatment strategies.
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Chiowchanwisawakit P, Pithukpakorn M, Luangtrakool K, Permpikul P. HLA-B*27:04 associated with enthesitis and younger age of onset, and HLA-B allele profile in patients with ankylosing spondylitis in Thailand: A cross-sectional study. Int J Rheum Dis 2021; 24:411-417. [PMID: 33448675 DOI: 10.1111/1756-185x.14055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/19/2020] [Accepted: 12/17/2020] [Indexed: 11/28/2022]
Abstract
AIM The aims of this study were to estimate human leukocyte antigen (HLA)-B allele frequency, to identify alleles associated with ankylosing spondylitis (AS), and to explore manifestations in various HLA-B*27 in Thai AS patients. METHODS This was a cross-sectional study. Thai patients older than 18 years with diagnosed AS according to modified New York criteria who visited Siriraj Hospital (Bangkok, Thailand) were consecutively enrolled. HLA-B alleles were determined by reverse sequence-specific oligonucleotide assays, and were assigned at a 4-digit resolution. HLA-B alleles of 334 unrelated healthy Thai donors who participated in a previous phase 2b dengue vaccine clinical trial were included as controls. Odds ratio (OR) and Fisher's exact test were used to estimate association between allele and AS. The P value significance threshold was calculated according to Bonferroni. RESULTS Among the 88 patients who were recruited, 34 HLA-B alleles were identified, and all patients were heterozygous. The prevalence of HLA-B*27 was 89.8%, and 4 alleles of HLA-B*27 were identified. HLA-B*27:04 (OR: 39.4, P < .0001) and HLA-B*27:05 (OR: 13.8, P = .0011) were associated with AS. In contrast, HLA-B*27:06 was not found to be associated with AS (OR: 0.4, P = .241). AS patients carrying HLA-B*27:04 were more likely to have enthesitis and younger age at onset than those carrying HLA-B*27:05. CONCLUSIONS HLA-B*27:04 and HLA-B*27:05 were both found to be strongly associated with Thai AS. HLA-B*27:06 showed a neutral allele for Thai AS. AS patients with HLA-B*27:04 had more enthesitis and younger age at onset than those with HLA-B*27:05.
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Affiliation(s)
- Praveena Chiowchanwisawakit
- Division of Rheumatology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Manop Pithukpakorn
- Division of Medical Genetics, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Komon Luangtrakool
- Department of Transfusion Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Parichart Permpikul
- Department of Transfusion Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Huang X, Xu Y, Chen W, Zhu T, He L, Wang S, Peng S, Mei S, Wang Y, Zhao J. The genetic contribution of HLA-E*01:03 and HLA-E*01:03-G*01:01 to Posner-Schlossman syndrome in southern Chinese. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:749. [PMID: 32042765 DOI: 10.21037/atm.2019.11.70] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Background The polymorphisms of classical HLA-Ia and HLA-II loci have been associated with Posner-Schlossman syndrome (PSS) in the southern Chinese population. However, the associations of non-classical HLA-Ib (e.g., HLA-E and HLA-G) loci with PSS have not been reported for in the southern Chinese population. This study aimed to evaluate the associations of the HLA-E and HLA-G loci with PSS in a southern Chinese Han population group. Methods Ninety-seven unrelated patients with PSS and 90 ethnically matched control subjects were recruited from the Shenzhen Eye Hospital in China. The full-length sequences of HLA-E and HLA-G genes were amplified by long-range high-fidelity PCR, and the third exon of the HLA-E gene and the coding region of the HLA-G gene were sequenced. Results The allele frequency of HLA-E*01:03 in patients with PSS was significantly higher than that in the control group (P=0.017, corrected P=0.034, OR =1.66). The genotype frequencies of HLA-E*01:01/01:03 and HLA-E*01:03/01:03 in the PSS group were significantly higher than that in the control group (P=0.027, OR =2.62; P=0.011, OR =3.05; respectively). There were no significant differences in the frequency of HLA-G alleles and genotypes between the two groups (all P>0.05). The haplotype frequency of HLA-E*01:03-G*01:01 in the PSS group was significantly higher than that in the control group (P=0.019, OR =1.63), although this association did not survive the Bonferroni correction (corrected P=0.13). Conclusions This study proved for the first time that HLA-E*01:03 and HLA-E*01:03-G*01:01 might be risk factors for PSS.
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Affiliation(s)
- Xiaosheng Huang
- School of Ophthalmology & Optometry Affiliated to Shenzhen University, Shenzhen 518040, China.,Shenzhen Eye Institute, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen 518040, China
| | - Yunping Xu
- Institution of Transfusion Medicine, Shenzhen Blood Center, Shenzhen 518035, China
| | - Wenchieh Chen
- Shenzhen Eye Institute, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen 518040, China
| | - Tianhui Zhu
- School of Ophthalmology & Optometry Affiliated to Shenzhen University, Shenzhen 518040, China.,Shenzhen Eye Institute, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen 518040, China
| | - Liumei He
- Institution of Transfusion Medicine, Shenzhen Blood Center, Shenzhen 518035, China
| | - Songxing Wang
- Institution of Transfusion Medicine, Shenzhen Blood Center, Shenzhen 518035, China
| | - Shiming Peng
- School of Ophthalmology & Optometry Affiliated to Shenzhen University, Shenzhen 518040, China.,Shenzhen Eye Institute, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen 518040, China
| | - Shaoyi Mei
- School of Ophthalmology & Optometry Affiliated to Shenzhen University, Shenzhen 518040, China.,Shenzhen Eye Institute, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen 518040, China
| | - Yan Wang
- Shenzhen Eye Institute, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen 518040, China
| | - Jun Zhao
- School of Ophthalmology & Optometry Affiliated to Shenzhen University, Shenzhen 518040, China.,Shenzhen Eye Institute, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen 518040, China
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Shih YJ, Yang YH, Lin CY, Chang CL, Chiang BL. Enthesitis-related arthritis is the most common category of juvenile idiopathic arthritis in Taiwan and presents persistent active disease. Pediatr Rheumatol Online J 2019; 17:58. [PMID: 31443722 PMCID: PMC6708211 DOI: 10.1186/s12969-019-0363-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 08/12/2019] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Juvenile idiopathic arthritis (JIA) has been categorized into seven different categories according to the International League of Associations for Rheumatology (ILAR) criteria. Enthesitis-related arthritis (ERA) was found to represent the largest category in a Taiwanese cohort study. The aim in this study was to compare the clinical characteristics, treatments, and outcomes of ERA in a single tertiary center in Taiwan, as compared to those of other categories of JIA. Furthermore, we determined patients' characteristics and risk factors that can help assess the outcomes in ERA. METHODS A retrospective chart review of all patients with JIA referred to a pediatric rheumatology clinic in the National Taiwan University Hospital between 1993 and 2018 were identified according to ILAR criteria. Outcomes were assessed based on the Wallace criteria to categorize patients into active and non-active, including inactive, remission on medication, and remission off medication, groups. A subset of samples was further tested by DNA sequencing to identify HLA-B27 subtypes. RESULTS One-hundred and eighty-three patients were included in the study, with a mean of 8 years' follow-up. ERA was the single largest category of JIA (39.9%); psoriasis and undifferentiated JIA were both the least common type (0.5%). ERA was male predominant (86%), had a late age of onset (11.0 ± 3.2 years), and the majority of ERA patients was HLA-B27-positive (97%). Of 25 HLA-B27-positive ERA patients checked by HLA-B27 sequencing, 23 were B*27:04 and 2 were B*27:05. ERA patients were significantly less likely to achieve non-active status compared to patients with persistent oligoarthritis (P = 0.036). In terms of treatment response to TNF-α inhibitors in methotrexate-refractory ERA, 26 patients remained active and only 11 patients (30%) achieved a non-active status. Sacroiliitis was a risk factor contributing to poorer treatment response in ERA (P = 0.006). CONCLUSION ERA represented the most common category of JIA in Taiwan. Those ERA patients with sacroiliitis were likely to have persistent active disease and may require a more aggressive treatment strategy to improve their outcomes.
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Affiliation(s)
- Yang-Jen Shih
- Department of Pediatrics, Taipei City Hospital, Zhongxing Branch, Taipei, Taiwan ,0000 0004 0546 0241grid.19188.39Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Zhongshan South Road, Zhongzheng District, Taipei, 100 Taiwan
| | - Yao-Hsu Yang
- Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Zhongshan South Road, Zhongzheng District, Taipei, 100, Taiwan. .,Department of Pediatrics, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu, Taiwan.
| | - Chun-Ying Lin
- 0000 0004 0572 7815grid.412094.aDepartment of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chia-Ling Chang
- 0000 0004 0572 7815grid.412094.aDepartment of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Bor-Luen Chiang
- 0000 0004 0546 0241grid.19188.39Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Zhongshan South Road, Zhongzheng District, Taipei, 100 Taiwan
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10
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Luo F, Zhao Z, Zhang J, Leng J. Comparison of HLA-B*27 subtypes between Chinese patients with ankylosing spondylitis and non-ankylosing spondylitis carriers. J Int Med Res 2019; 47:3171-3178. [PMID: 31177886 PMCID: PMC6683902 DOI: 10.1177/0300060519853929] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objective To investigate the distribution of subtypes between HLA-B*27 (+) patients with ankylosing spondylitis (AS) and carriers. Methods This case–control study recruited Chinese Han patients with HLA-B*27 (+) AS from six hospitals in Zhejiang Province, China between 2013 and 2018. Patients who were examined for HLA-B*27 because of back pain or arthralgia but who did not have AS or arthritis were recruited as controls. HLA-B*27 target DNA was amplified by amplification refractory mutation systems and HLA-B*27 subtypes were determined by sequencing. Results The positive rate of HLA-B*27 was significantly higher in the AS group than in the control group. In AS patients, HLA-B*2704 was predominant at 86.4%, followed by HLA-B*2705 at 12.6%; HLA-B*2704 and HLA-B*2705 were found in 70.0% and 10.0% of controls, respectively. HLA-B*2702 and HLA-B*2706 were detected at low frequencies in the control group, while the rare subtype HLA-B*2715 was only observed in two (1.0%) patients with AS. HLA-B*2707 was not detected in AS or control groups. Conclusion HLA-B*2704 is the predominant subtype among patients with AS and carriers in southeast China.
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Affiliation(s)
- Fangjun Luo
- 1 Department of Clinical Laboratory, Affiliated Zhuji Hospital of Wenzhou Medical University, Zhuji, China
| | - Zhigang Zhao
- 2 Zhejiang Lishui Central Hospital, Lishui Hospital of Zhejiang University, Lishui, China
| | - Jie Zhang
- 3 Shanghai ZJ Bio-Tech Co., Ltd, Shanghai, China
| | - Jianhang Leng
- 4 Central Laboratory of Hangzhou First People's Hospital, Hangzhou, China
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11
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Fallahi S. Influence of HLA-B27 Subtypes on Ankylosing Spondylitis Phenotype: Comment on the Article by Akassou et al. CLINICAL MEDICINE INSIGHTS-ARTHRITIS AND MUSCULOSKELETAL DISORDERS 2018; 11:1179544118785123. [PMID: 30013411 PMCID: PMC6039905 DOI: 10.1177/1179544118785123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 05/27/2018] [Indexed: 11/16/2022]
Affiliation(s)
- Sasan Fallahi
- Internal Medicine Division, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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12
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Akassou A, Bakri Y. Does HLA-B27 Status Influence Ankylosing Spondylitis Phenotype? CLINICAL MEDICINE INSIGHTS-ARTHRITIS AND MUSCULOSKELETAL DISORDERS 2018; 11:1179544117751627. [PMID: 29343996 PMCID: PMC5764146 DOI: 10.1177/1179544117751627] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Accepted: 12/07/2017] [Indexed: 12/16/2022]
Abstract
The association of HLA-B27 with ankylosing spondylitis (AS) remains as one of the intriguing models that could exist between a molecule and human disease in medicine. Although it was reported in 1973, its contribution to AS and related spondyloarthritis continues to be a major challenge for scientific community. It is important to understand its etiopathogenic mechanism and its functions in these diseases. Although the diagnostic and prognostic roles of HLA-B27 in AS are still debated, there is an increasing interest for HLA-B27–based effects especially in HLA-B27(+) patients with AS. This review will focus in the examination of published reports regarding the influence of HLA-B27 status on the demographic and clinical features in AS, with specific interest to its role on AS severity.
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Affiliation(s)
- Amal Akassou
- Laboratory of Biochemistry and Immunology, Faculty of Sciences, Mohammed V University Agdal, Rabat, Morocco
| | - Youssef Bakri
- Laboratory of Biochemistry and Immunology, Faculty of Sciences, Mohammed V University Agdal, Rabat, Morocco
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13
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Lin H, Gong YZ. Association of HLA-B27 with ankylosing spondylitis and clinical features of the HLA-B27-associated ankylosing spondylitis: a meta-analysis. Rheumatol Int 2017; 37:1267-1280. [DOI: 10.1007/s00296-017-3741-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 05/11/2017] [Indexed: 01/27/2023]
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14
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Bacchiega ABS, Balbi GGM, Ochtrop MLG, de Andrade FA, Levy RA, Baraliakos X. Ocular involvement in patients with spondyloarthritis. Rheumatology (Oxford) 2017; 56:2060-2067. [DOI: 10.1093/rheumatology/kex057] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Indexed: 01/20/2023] Open
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15
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Khan MA. An Update on the Genetic Polymorphism of HLA-B*27 With 213 Alleles Encompassing 160 Subtypes (and Still Counting). Curr Rheumatol Rep 2017; 19:9. [DOI: 10.1007/s11926-017-0640-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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16
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Li H, Li Q, Ji C, Gu J. Ankylosing Spondylitis Patients with HLA-B*2704 have More Uveitis than Patients with HLA-B*2705 in a North Chinese Population. Ocul Immunol Inflamm 2016; 26:65-69. [PMID: 27428175 DOI: 10.1080/09273948.2016.1188967] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE To investigate the correlation between clinical features of ankylosing spondylitis (AS) and different human leukocyte antigen (HLA)-B27 subtypes. METHODS We conducted a cross-sectional study of 216 patients with AS. HLA-B27 and its subtypes were detected by polymerase chain reaction with sequence specific primer (PCR-SSP). Clinical features were compared between the different HLA-B27 subtypes. A meta-analysis on uveitis frequencies in AS patients with HLA-B*2705 vs 2704 was performed. RESULTS The most prevalent subtypes of HLA-B27 were HLA-B*2704 (66.1%) and HLA-B*2705 (32.2%). There were 57 HLA-B27-positive AS patients with the history of uveitis; 45 were B*2704 and 12 were B*2705. Patients with B*2704 had more uveitis than B*2705 (p = 0.021). After meta-analysis, there was no significant difference in the presence of uveitis between HLA-B*2704 and HLA-B*2705. CONCLUSIONS AS patients with B*2704 have a higher risk of uveitis than AS with B*2705 in a north Chinese people.
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Affiliation(s)
- Haibo Li
- a Third Affiliated Hospital of Sun Yat-sen University, General Hospital of Ningxia Medical University , Department of Rheumatology , Yinchuan , China
| | - Qiuxia Li
- b Third Affiliated Hospital of Sun Yat-sen University , Department of Rheumatology , Guangzhou , China
| | - Chen Ji
- c General Hospital of Ningxia Medical University , Department of Rheumatology , Yinchuan , China
| | - Jieruo Gu
- b Third Affiliated Hospital of Sun Yat-sen University , Department of Rheumatology , Guangzhou , China
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17
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Siak J, Jansen A, Waduthantri S, Teoh CS, Jap A, Chee SP. The Pattern of Uveitis among Chinese, Malays, and Indians in Singapore. Ocul Immunol Inflamm 2016; 25:S81-S93. [DOI: 10.1080/09273948.2016.1188968] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Jay Siak
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore
| | - Anne Jansen
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore
| | | | - Chin-Sheng Teoh
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore
| | - Aliza Jap
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore
| | - Soon-Phaik Chee
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Duke-NUS Medical School, Singapore
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18
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del Río-Martínez P, Navarro-Compán V, Díaz-Miguel C, Almodóvar R, Mulero J, De Miguel E. Similarities and differences between patients fulfilling axial and peripheral ASAS criteria for spondyloarthritis: Results from the Esperanza Cohort. Semin Arthritis Rheum 2016; 45:400-3. [DOI: 10.1016/j.semarthrit.2015.09.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 06/28/2015] [Accepted: 09/11/2015] [Indexed: 02/03/2023]
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19
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El Mouraghi I, Ouarour A, Ghozlani I, Collantes E, Solana R, El Maghraoui A. Polymorphisms of HLA-A, -B, -Cw and DRB1 antigens in Moroccan patients with ankylosing spondylitis and a comparison of clinical features with frequencies of HLA-B*27. ACTA ACUST UNITED AC 2015; 85:108-16. [PMID: 25626601 DOI: 10.1111/tan.12515] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 10/29/2014] [Accepted: 12/17/2014] [Indexed: 01/18/2023]
Abstract
Ankylosing spondylitis (AS) is very often associated with human leukocyte antigen (HLA), particularly HLA-B*27. However, the strength of this association and clinical features may vary in different ethnic groups. Our study aims to assess the distribution of HLA-A, -B, -Cw and DRB1 alleles in Moroccan patients with AS and to compare the clinical features of AS and the frequencies of HLA-B27 in patients from Morocco with other series. Seventy-five patients diagnosed with AS and assessed for clinical manifestations were selected and compared to 100 healthy controls. HLA class I and II antigens were typed by polymerase chain reaction sequence-specific oligonucleotide. HLA-B27 subtypes were studied by polymerase chain reaction amplification with sequence-specific primers. HLA-B27 was found in 64% of patients. It was positively associated with younger age at disease onset, family history, and uveitis while it had a negative association with late onset. Six B*27 subtypes were identified in the AS group. HLA-B*2705 and B*2702 were the most common observed subtypes. Among other HLA genes, a significant increase in the prevalence of HLA-Cw*02 and HLA-DRB*15 was found in AS patients. HLA-B27 is involved in the predisposition of AS in the Moroccan population. HLA-B*2705 and B*2702 were the predominant subtypes supporting previous reports in Caucasian spondyloarthropathies. Other HLA genes, HLA-Cw*02 and HLA-DRB1*15, seem to confer predisposing effect to the disease. However, the lower frequency of HLA-B27 compared to the literature in our study suggests the existence of different genetic and/or environmental factors in Morocco.
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Affiliation(s)
- I El Mouraghi
- Department of Biology, Faculty of Sciences, University Abdelmalek Essaidi, Tétouan, Morocco
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20
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Anti-TNFα agents and methotrexate in spondyloarthritis related uveitis in a Chinese population. Clin Rheumatol 2015; 34:1913-20. [DOI: 10.1007/s10067-015-2989-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 05/16/2015] [Accepted: 06/03/2015] [Indexed: 01/29/2023]
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