David T.Y. Yu, MD; S. Yoon Choo, MD; Terry Schaack, MD
A unique feature of patients with ankylosing spondylitis and reactive arthritis is that almost all share the HLA type B27. The primary structures of the HLA-B27 antigens have been determined. At least six variants exist. However, disease predisposition does not appear to be restricted to a particular variant. One hypothesis about the pathogenesis of arthritis is that the bacteria that cause the arthritis carry components that are cross-reactive with HLA-B27 antigens. Several reactive bacterial components have indeed been identified using monoclonal anti-HLA-B27 antibodies. Even more striking is the identification, through a computerized search, of a Klebsiella protein. This protein carries a stretch of six amino acids identical to residues 72 to 77 of two of the HLA-B27 variants. A synthetic peptide carrying these six amino acids of HLA-B27 protein is reactive with serum antibodies in some patients with arthritis. With this knowledge, investigators will be able to formulate new approaches for examining the pathogenesis of HLA-B27-associated arthritis.
Yu DT, Choo SY, Schaack T. Molecular Mimicry in HLA-B27-Related Arthritis. Ann Intern Med. ;111:581–591. doi: 10.7326/0003-4819-111-7-581
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Published: Ann Intern Med. 1989;111(7):581-591.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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