[HLA-antigens and some pathogenetic aspects of reactive arthritis].
OBJECTIVE
Investigation of associations of reactive arthritis (ReA) with histocompatibility antigens class I and II and determination of new approaches to assessment of association ReA with antigen HLA B27.


METHODS
118 ReA patients with associated intestinal and 82 ReA patients with associated urogenital infection were studied. The infection was identified bacteriologically, with agglutination reaction, enzyme immunoassay, direct and indirect immunofluorescence, culturing. HLA-antigens were studied in lymphocytotoxic test: locus A, B and C in all the patients, DR in 65 patients.


RESULTS
ReA triggers were intracellularly parasite bacteria: facultative parasites in the enterocolitic variant (Yersinia, as a rule), obligate parasite in the urogenital (Chlamidia, as a rule). HLA B27 antigen was discovered in 77.5% of patients (RR 45.8), HLA DR1--in 48.4% of patients (RR 3.3). In urogenital variant HLA B27 antigen occurred more frequently than in enterocolitic: 87.8% (RR 95.6) versus 70.3% (RR 31.5); p < 0.01). In HLA-B27-positive patients compared to HLA-B27-negative ones there were higher ESR (p < 0.001), leukocyte count (p < 0.05), concentrations of CRP and alpha-2-globulins (p < 0.001).


CONCLUSIONS
In HLA-B27-subjects optimal conditions exist for generalization of obligate parasites and favorable for production of facultative ones. The degree of association of ReA with HLA B27 antigens is dependent on adaptive features of microorganisms appearing in the process of evolution--obligaty and facultativeness of their internal parasitivity.
Sidel'nikova
S M
SM
Kut'ina
R M
RM
Zotikov
E A
EA
D000328:Adult; D016918:Arthritis, Reactive / Q000097:blood / Q000276:immunology*; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism; D002690:Chlamydia Infections / Q000097:blood / Q000276:immunology; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D015791:HLA-A3 Antigen / Q000276:immunology; D015796:HLA-B27 Antigen / Q000276:immunology*; D015798:HLA-DR1 Antigen / Q000276:immunology*; D015803:HLA-DR3 Antigen / Q000276:immunology; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D000091402:Prohibitins; D015007:Yersinia / Q000302:isolation & purification; D015009:Yersinia Infections / Q000097:blood / Q000276:immunology
D015791:HLA-A3 Antigen; D015796:HLA-B27 Antigen; D015798:HLA-DR1 Antigen; D015803:HLA-DR3 Antigen; C000717331:PHB2 protein, human; D000091402:Prohibitins; D002097:C-Reactive Protein
HLA-antigeny i nekotorye patogeneticheskie aspekty reaktivnykh artritov.