Molecular mimicry in HLA-B27-related arthritis.
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
D T
DT
Department of Medicine, UCLA School of Medicine 90024.
Choo
S Y
SY
Schaack
T
T
D000483:Alleles; D001168:Arthritis / Q000209:etiology / Q000276:immunology*; D001419:Bacteria / Q000276:immunology; D001424:Bacterial Infections / Q000150:complications; D003429:Cross Reactions; D004198:Disease Susceptibility / Q000276:immunology; D015235:HLA-B Antigens / Q000032:analysis* / Q000235:genetics / Q000276:immunology; D015796:HLA-B27 Antigen; D006801:Humans; D013167:Spondylitis, Ankylosing / Q000276:immunology
D015235:HLA-B Antigens; D015796:HLA-B27 Antigen