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I read the interesting paper entitled Spondyloarthritis in North Africa: an update which has been published by Silmani et al. in clinical rheumatology [1]. I decided to critique a small part of it briefly, which is about the clinical relevance of HLA-B*27 polymorphisms in patients with ankylosing spondylitis (AS) in Asia. They included in their paper: “This is contrary to the findings reported for Asian populations, for whom HLA-B*27 polymorphisms may affect disease phenotype, particularly B*2704 and B*27015, which are associated with earlier disease onset and more frequent uveitis than B*2705 among Asian patients” [1]. One of the articles cited by Salmani and her colleagues on this subject is the article by Fallahi et al. [2]. It should be noted that in Fallahi et al.’s study, none of the patients with AS was HLA-B*27015 positive at all and the HLA-B27-positive polymorphisms were as follows: 48.4% B*2705, 42.6% B*2702, 5.7% B*2704, and 3.3% B*2707. As can be seen, HLA-B*2704 and HLA-B*2707 subtypes account for a small percentage. Also, earlier disease onset and uveitis were not more frequent significantly than the more common subtypes (including HLA-B*2705 and HLA-B*2702) in this study. However, clinical trends toward less dorsal kyphosis and less decrease in cervical slope (without statistically significance) were observed in patients with B*2704 and B*2707 [2]. In conclusion, uveitis and earlier onset of AS may be more frequent for HLA-B*2704 or HLA-B*27015 among China and Far East population according to some researchers [3, 4]. However, this cannot be extended to all parts of Asia, especially Iran or Middle East Asia.
References
Slimani S, Hamdi W, Nassar K, Kalla AA (2021) Spondyloarthritis in North Africa: an update. Clin Rheumatol. https://doi.org/10.1007/s10067-021-05630-w
Fallahi S, Mahmoudi M, Nicknam MH et al (2013) Effect of HLAB*27 and its subtypes on clinical manifestations and severity of ankylosing spondylitis in Iranian patients. Iran J Allergy Asthma Immunol 12:321–330
Mou Y, Zhang P, Li Q et al (2015) Clinical features in juvenile onset ankylosing spondylitis patients carrying different B27 subtypes. Biomed Res Int 2015:594878
Qi J, Li Q, Lin Z, Liao Z, Wei Q, Cao S, Rong J, Hu Z, Yang M, Zhang Y, Lv Q, Huang J, Pan Y, Wu Y, Jin O, Li T, Gu J (2013) Higher risk of uveitis and dactylitis and older age of onset among ankylosing spondylitis patients with HLA-B*2705 than patients with HLA-B*2704 in the Chinese population. Tissue Antigens 82:380–386
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Fallahi, S. Are the earlier disease onset and uveitis affected by the HLA-B*27 subtypes in ankylosing spondylitis? Comments on the article by Silmani et al.. Clin Rheumatol 40, 2513 (2021). https://doi.org/10.1007/s10067-021-05685-9
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DOI: https://doi.org/10.1007/s10067-021-05685-9