Rheumatology International

, Volume 29, Issue 9, pp 1013–1016 | Cite as

Association of various inflammatory diseases with human leukocyte antigens B27, B7, Bw4 and Bw6 in patients with SSA

Original Article


Seronegative spondyloarthropathies (SSA) are a group of inflammatory disorders, which clinically involve the axial skeleton and the sacroiliiac and shoulder joints. The aim of the present study was to study the association of HLA B27, B7, Bw4 and Bw6 with some inflammatory diseases, in SSA patients in our area. A total of 220 SSA patients were studied and HLA typing for these antigens were done by the complement-mediated microcytotoxicity method. The total positivity of B27 was found to be 68.64% in SSA patients. Tubercular infection (χ2 = 8.06) and acute anterior uveitis (χ2 = 6.19) were found to be statistically significant (P < 0.05) in B27-positive SSA patients. Tuberculosis was also found to be significantly (χ2 = 6.40) associated with Bw4. In SSA urinary tract infection, gastrointestinal infection and streptococcal infection were not significantly associated with B27, B7, Bw4 or Bw6 antigens. Our study concludes that microbial infections do have some pathogenic role in causing SSA.


Seronegative spondyloarthopathy HLA antigens Tuberculosis Acute anterior uveitis Urinary tract infection Gastrointestinal infection Streptococcal infection 


  1. 1.
    Dhurandhar PS, Shankarkumar U (2007) HLA association in seronegative spondyloarthritis patients from Mumbai, India. Int J Hum Genet 7:235–239Google Scholar
  2. 2.
    Brewerton DA, Caffrey MFP, Hart FD, James DCO, Nichols A, Sturrock RD (1973) Ankylosing spondylitis and HLA-B27. Lancet 1:904–907. doi:10.1016/S0140-6736(73)91360-3 PubMedCrossRefGoogle Scholar
  3. 3.
    Khan MA (1988) Genetics of HLA-B27. Br J Rheumatol 27:6–11PubMedGoogle Scholar
  4. 4.
    Bjorkman PJ, Saper MA, Samraoui B, Bennett WS, Strominger JL, Wiley DC (1987) Structure of human class I histocompatibility antigen, HLA-A2. Nature 329:506–512. doi:10.1038/329506a0 PubMedCrossRefGoogle Scholar
  5. 5.
    Benjamin R, Parham P (1990) Guilt by association: HLA-B27 and ankylosing spondylitis. Immunol Today 11:137–142. doi:10.1016/0167-5699(90)90051-A PubMedCrossRefGoogle Scholar
  6. 6.
    Egringer A, Cowling P, Ngwa Suh et al (1976) Cross-reactivity between Klebsiela aerogenes species and HLA-B27 lymphocyte antigen as an aetiological factor in ankylosing spondylitis. In: Dausset J, Svejgaad A (eds) HLA and disease. Paris, INSERM, p 27Google Scholar
  7. 7.
    Theofilopoulos AN (1995) The basis of autoimmunity: Part 1. Mechanisms of aberrant self-recognition. Immunol Today 16:90–98. doi:10.1016/0167-5699(95)80095-6 PubMedCrossRefGoogle Scholar
  8. 8.
    Murray CJ, Styblo K, Rouillon A (1990) Tuberculosis in developing countries: burden, intervention and cost. Bull Int Union Tuberc Lung Dis 65:6–24PubMedGoogle Scholar
  9. 9.
    Hafez M, el-Salab S, el-Shennawy F, Bassiony MR (1985) HLA-antigens and tuberculosis in the Egyptian population. Tubercle 66:35–40. doi:10.1016/0041-3879(85)90051-0 PubMedCrossRefGoogle Scholar
  10. 10.
    Zervas J, Constantopoulos C, Toubis M, Anagnostopoulos D, Costovoulou V (1998) HLA-A and B antigens and pulmonary tuberculosis in Greeks. Br J Dis Chest 81:147–149. doi:10.1016/0007-0971(87)90132-X CrossRefGoogle Scholar
  11. 11.
    Hawkin BR, Higgins DA, Chan SL, Lowrie DB, Mitchison DA, Girling DJ (1988) HLA typing in the Hong Kong Chest Service/British Medical Research Council study of factors associated with the breakdown to active tuberculosis of inactive pulmonary lesions. Am Rev Respir Dis 138:1616–1621Google Scholar
  12. 12.
    Ali A, Samson CM (2007) Seronegative spondyloarthropathies and the eye. Curr Opin Ophthalmol 18:476–480. doi:10.1097/ICU.0b013e3282f0fda2 PubMedCrossRefGoogle Scholar
  13. 13.
    Hannu T, Puolakkainen M, Leirisalo-Repo M (1999) Chyamydia pneumaoniae as a triggering infection in reactive arthritis. Rheumatology 38:411–414. doi:10.1093/rheumatology/38.5.411 PubMedCrossRefGoogle Scholar
  14. 14.
    Sieper J (2004) Disease mechanisms in reactive arthritis. Curr Rheumatol Rep 6:110–116. doi:10.1007/s11926-004-0055-7 PubMedCrossRefGoogle Scholar
  15. 15.
    Valtonen VV, Leirisalo M, Pentikainen PJ et al (1985) Triggering infections in reactive arthritis. Ann Rheum Dis 44:399–405PubMedCrossRefGoogle Scholar
  16. 16.
    Dougados M, van der Linden S, Juhlin R et al (1991) The European Spondyloarthropathy Study Group preliminary criteria for the classification of spondyloarthropathy. Arthritis Rheum 34:1218–1227. doi:10.1002/art.1780341003 PubMedCrossRefGoogle Scholar
  17. 17.
    Terasaki PI, McClelland JD (1964) Microdroplet assay of human serum cytotoxins. Nature 204:998–1000PubMedCrossRefGoogle Scholar
  18. 18.
    Mehra NK (1989) Basic methods in HLA-DNA technology. Technical manual published during the DBT-sponsored training workshop on HLA-DNA technology, Sagar publishers, New DelhiGoogle Scholar
  19. 19.
    Selvaraj P (2004) Host genetics and tuberculosis susceptibility. Curr Sci 86:115–121Google Scholar
  20. 20.
    Huang F, Wang L, Zhang J, Deng X, Guo J, Zhang Y (2006) Risk of tuberculosis in a Chinese registry of rheumatoid arthritis and ankylosing spondylitis for tumour necrosis-α antagonists. APLAR J Rheumatol 9:170–174. doi:10.1111/j.1479-8077.2006.00193.x CrossRefGoogle Scholar
  21. 21.
    Gupta SS, Jain IS, Jain GC, Deodhar SD (1978) HLA antigens in acute anterior uveitis in North Indians. Indian J Ophthalmol 26:26–29Google Scholar
  22. 22.
    van der Heijden IM, Wilbrink B, Schouls LM, van Embden JDA, Breedveld FC, Tak PP (1999) Detection of mycobacteria in joint samples from patients with arthritis using a genus-specific polymerase chain reaction and sequence analysis. Rheumatology 38:547–553. doi:10.1093/rheumatology/38.6.547 PubMedCrossRefGoogle Scholar
  23. 23.
    Gogia A, Kakar A, Gupta PS (2007) Skeletan tuberculosis mimicking seronegative spondyloarthropathy. J Assoc Physicians India 55:740–741PubMedGoogle Scholar
  24. 24.
    Linssen A, Meenken C (1995) Outcomes of HLA B27-positive and HLA B27-negative acute anterior uveitis. Am J Ophthalmol 120:351–361PubMedGoogle Scholar
  25. 25.
    Monnet D, Breban M, Hudry C, Dougados M, Brezin AP (2004) Ophthalmic findings and frequency of extraocular manifestations in patients with HLA B27 uveitis: a study of 175 cases. Ophthalmology 111:802–809. doi:10.1016/j.ophtha.2003.07.011 PubMedCrossRefGoogle Scholar
  26. 26.
    Zochling J, Bohl-Buhler MHJ, Baraliakos X, Feldtkeller E, Braun J (2006) Infection and work stress are potential triggers of ankylosing spondylitis. Clin Rheumatol 25:660–666. doi:10.1007/s10067-005-0131-z PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Sangeeta Singh
    • 1
  • Gyanendra K. Sonkar
    • 1
  • Usha Singh
    • 1
  1. 1.Department of Pathology, Institute of Medical SciencesBanaras Hindu UniversityVaranasiIndia

Personalised recommendations