HLA-B27 Subtypes in Korean Patients with Ankylosing Spondylitis

Kyung-Sun Park; So-Young Kang; Woo-In Lee

doi:10.3343/kjlm.2008.28.1.46

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Park, Kang, and Lee: HLA-B27 Subtypes in Korean Patients with Ankylosing Spondylitis

Original Article

Korean J Leg Med 2008;28(1):46-52.

Published online: 14 February 2008

DOI: https://doi.org/10.3343/kjlm.2008.28.1.46

HLA-B27 Subtypes in Korean Patients with Ankylosing Spondylitis

Kyung-Sun Park, M.D., So-Young Kang, M.D., Woo-In Lee, M.D.

Department of Laboratory Medicine, Kyung Hee University College of Medicine, Seoul, Korea

Received 8 February 200717 September 2007 Accepted 23 October 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

HLA-B27 is strongly associated with ankylosing spondylitis (AS), and its subtypes differ in their ethnic distribution. Studies worldwide have shown that B^∗2701, B^∗2702, B^∗2704, B^∗2705, B^∗2707, B^∗2708, B^∗2714, B^∗2715, and B^∗2719 are AS-predisposing subtypes, whereas B^∗2706 and B^∗2709 are reported to be negatively associated with AS. The aim of this study was to investigate HLA-B27 polymorphism and clinical features according to subtypes in Korean patients with AS.

Methods

Two hundred thirty samples from patients with impression of AS were analyzed by polymerase chain reaction using a sequence-specific primers (PCR-SSP) method. Pel-Freez SSP Unitray HLA-B^∗27 kit (Dynal Biotech, USA) including 16 primers was used to define HLA-B27 subtypes from B^∗2701 to B^∗2735.

Results

Among 230 samples from patients with impression of AS, 171 were HLA-B27 positive, and among 160 patients diagnosed as AS, 154 (96.3%) were HLA-B27 positive, while 17 patients not diagnosed as AS were HLA-B27 positive. Among 154 HLA-B27 positive patients with AS, 142 (92.2%) were typed as B^∗2705 and 9 (5.8%) were typed as B^∗2704. Three cases (1.9%) could be interpreted only variously because of their HLA-B27 homogeneous alleles. Between B^∗2705 and B^∗2704, no specific HLA-B27 subtype appeared to contribute to AS susceptibility (P=0.60). Difference in clinical features between B^∗2705 and B^∗2704 could not be found in this study (P>0.05).

Conclusions

This study verified that HLA-B27 (96.3%) is strongly associated with AS and identified that the major subtypes of HLA-B27 positive patients with AS in Korea are B^∗2705 (92.2%) and B^∗2704 (5.8%).

Keywords: Ankylosing spondylitis, HLA-B27 subtypes, PCR-SSP method

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Fig. 1.

Amplification patterns of HLA-B27 positive and negative samples.

^∗Each well has internal control (1,200 bp). M, size marker; N, HLA-B27 negative control.

Table 1.

Number and frequency of HLA-B27 in the patients with and without ankylosing spondylitis

	AS	non AS	Total	P value^∗
HLA-B27 (+)	154 (96.3%)	17 (24.3%)	171	<0.0001
HLA-B27 (–)	6 (3.7%)	53 (75.7%)	59
Total	160	70	230

^∗ Statistical difference of HLA-B27 positivity between AS and non AS was found (P<0.0001).

Abbreviation: AS, ankylosing spondylitis.

Table 2.

Number and frequency of HLA-B27 alleles detected in HLA-B27 positive patients

Allele	HLA-B27 positive patients (n=171)
Allele	AS (n=154)	non AS (n=17)	Total (n=171)	P value^†
B^∗2704	9 (5.8%)	0 (0.0%)	9 (5.3%)	0.60
B^∗2705	142 (92.2%)	16 (94.1%)	158 (92.4%)
B^∗2720	0 (0.0%)	1 (5.9%)	1 (0.6%)
Others	3 (1.9%)^∗	0 (0.0%)	3 (1.8%)

^∗ Others includes 2 cases that were B^∗2704 & B^∗2705/B^∗2704 & B^∗2728/B^∗2705 & B^∗2715/B^∗2710 & B^∗2704/ B^∗2710 & B^∗2704/B^∗2710 & B^∗ 2705/B^∗2710 & B^∗2715/B^∗2710 & B^∗2728 and 1 case that was B^∗2704 & B^∗2715/B^∗2704 & B^∗2731/B^∗2715 & B^∗2731. These 3 cases had HLA-B27 homogeneous alleles, which were identified by HLA-B low resolution typing.

^† Statistical difference of B^∗2705 and B^∗2704 between AS and non AS was not found (P=0.60).

Table 3.

Clinical features of patients with ankylosing spondylitis according to the HLA-B27 subtypes

Clinical features	AS (n=154)
Clinical features	B^∗2705 (n=142)	B^∗2704 (n=9)	Others^∗ (n=3)	Total (n=154)	P value^∗
Sex (M/F)	114/28	6/3	3/0	123/31
Age (mean yr)	30.1	32.1	28	30.0
Spondyloarthritis	142	9	3	154
	(100%)	(100%)	(100%)	(100%)
Peripheral arthritis	41	1	3	45	0.45
	(28.9%)	(11.1%)	(100%)	(29.2%)
Uveitis	20	1	2	23	1.00
	(14.1%)	(11.1%)	(66.7%)	(14.9%)
Enthesitis	10	1	0	11	0.50
	(7.0%)	(10.0%)	(0.0%)	(7.1%)
Family history	6	0	0	6	1.00
	(4.2%)	(0.0%)	(0.0%)	(3.9%)

^∗ See Table 2;

^† Statistical differences of clinical features between B^∗2705 and B^∗2704 were not found (P>0.05).

Table 4.

Clinical features of patients with ankylosing spondylitis according to HLA-B27 positivity

Clinical features	AS
Clinical features	HLA-B27 (+) (n=154)	HLA-B27 (–) (n=6)	P value^∗
Sex, M/F	114/28	5/1
Age (mean yr)	30.0	28
Spondyloarthritis	154 (100%)	6 (100%)
Peripheral arthritis	45 (29.2%)	1 (16.7%)	0.67
Uveitis	23 (14.9%)	1 (16.7%)	1.00
Enthesitis	11 (7.1%)	0 (0.0%)	1.00
Family history	6 (3.9%)	0 (0.0%)	1.00

^∗ Statistical differences of clinical features according to HLA-B27 positivity were not found (P>0.05).

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