SPONDYLOARTHRITIS INCLUDING PSORIATIC ARTHRITIS: Edited by Joerg ErmannHuman leucocyte antigen-B27 testing in clinical practice: a global perspectiveZiade, Nellya,b Author Information aSaint-Joseph University bHotel-Dieu de France Hospital, Beirut, Lebanon Correspondence to Nelly Ziade, Consultations Externes, Hotel-Dieu de France Hospital, Alfred Naccache blvd, Achrafieh, Beirut 1100, Lebanon. Tel: +9611612013; fax: +9611612013; e-mail: [email protected], [email protected] Current Opinion in Rheumatology 35(4):p 235-242, July 2023. | DOI: 10.1097/BOR.0000000000000946 Buy Metrics Abstract Purpose of review The association between human leucocyte antigen (HLA)-B27 and spondyloarthritis (SpA) was described half a century ago. New insights about pathophysiologic pathways and their role in bone formation were reported in recent years and will be discussed in this review. Recent findings There is a considerable variation in the association between HLA-B27 and SpA across the globe, with the strongest association reported in populations of Northern European and Asian descent and the lowest in the Middle East and Africa. Other genes are also involved in disease susceptibility, highlighting the importance of newly proposed weighted genetic scores to support the diagnosis. On the global level, the interaction between genetic background and gut dysbiosis seems critical for disease predisposition. As for the individual patient, the presence of HLA-B27 can have a significant influence on SpA diagnosis and disease phenotype. More importantly, new studies suggested a role for HLA-B27 in radiographic damage in the sacroiliac joints and the progression of bone formation in the spine. Summary Findings in recent years have enhanced our understanding of the role of HLA-B27 in the pathophysiology and in disease-related bone formation in SpA, which may pave the way for new therapeutic targets. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
