HLA-B<sup>*</sup>27亚型与脊柱关节炎临床表型的相关性研究进展

黄跃; 徐聪颖; 王赛赛; 李涯松

doi:10.16766/j.cnki.issn.1674-4152.004056

HLA-B^*27亚型与脊柱关节炎临床表型的相关性研究进展

doi: 10.16766/j.cnki.issn.1674-4152.004056

黄跃^{1, 2},
徐聪颖^{1, 2},
王赛赛²,
李涯松^2, ,

1.
浙江中医药大学第二临床医学院，浙江杭州 310053
2.
浙江省人民医院/杭州医学院附属人民医院风湿免疫科，浙江杭州 310014

基金项目:

国家中医药管理局-浙江省中医药管理局共建重点项目 GZY-ZJ-KJ-23047

浙江省医药卫生科技计划项目 2022KY052

详细信息

通讯作者:
李涯松，E-mail：lysong2@163.com

中图分类号: R681.53
计量
- 文章访问数: 16
- HTML全文浏览量: 12
- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2024-10-31
- 网络出版日期: 2025-09-04

Advances in the correlation between HLA-B^*27 subtypes and clinical phenotypes of spondyloarthritis

HUANG Yue^{1, 2},
XU Congying^{1, 2},
WANG Saisai²,
LI Yasong^{2
, ,}

1.
The Second Clinical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, China

摘要

摘要: 人类白细胞抗原B^*27(HLA-B^*27)与脊柱关节炎(SpA)的发病密切相关。B^*27不同亚型存在结构差异，在致病机制上也可能存在差异，并表现为不同的临床表型。B^*27亚型与SpA临床表型的相关性如下，(1)在已知B^*27的167个亚型中，大约有16种与SpA强相关，其中B^*2704、B^*2705是SpA患者最常见的亚型，B^*2702、B^*2707次之，这些亚型与B^*2706、B^*2709低SpA相关亚型相比，在蛋白分子层面有着更明显的错误折叠；(2)SpA临床病种与B^*27亚型的特点：强直性脊柱炎(AS)和银屑病关节炎(PsA)以B^*2704为主，反应性关节炎(ReA)和未分化脊柱关节炎(uSpA)以B^*2705为主，AS尚可见B^*27亚型双阳，赖特综合征(RS)多见于B^*2705、B^*2702；(3)B^*27亚型与SpA不同靶器官的相关性：B^*27阳性比阴性更易出现关节损伤、葡萄膜炎、心血管受累等，B^*2705、B^*2702等患者可能更易发生早发髋关节强直和胃肠炎，B^*2704更常出现视力受损和心血管疾病，B^*2715更易出现葡萄膜炎。因此，了解不同亚型临床表型的特点，对诊治SpA具有重要指导意义。
- 脊柱关节炎 /
- HLA-B^*27亚型 /
- 临床表型 /
- 相关性
Abstract: Human leukocyte antigen HLA-B^*27 (B^*27) is closely associated with the development of spondyloarthritis (SpA). Different subtypes of B^*27 exhibit structural variations, which may contribute to differences in pathogenic mechanisms and clinical phenotypes. The correlation between B^*27 subtypes and SpA clinical phenotypes is as follows, (1) Among the 167 known subtypes of B^*27, approximately 16 are strongly associated with SpA. B^*2704 and B^*2705 are the most common subtypes in SpA patients, followed by B^*2702 and B^*2707. These subtypes exhibited greater protein misfolding at the molecular level compared to B^*2706 and B^*2709, which are less associated with SpA. (2) Characterization of SpA clinical forms with B^*27 subtypes: ankylosing spondylitis (AS) and psoriatic arthritis (PsA) are primarily associated with B^*2704, whereas reactive arthritis (ReA) and undifferentiated spondyloarthritis (uSpA) are predominantly linked to B^*2705. Additionally, AS can present with double-positive B^*27 subtypes, and B^*2705, B^*2702 are mostly observed in Reiter ' s syndrome (RS). (3) Correlation between B^*27 subtypes and target organs of SpA: patients with B^*27 positivity are more likely to develop joint damage, uveitis, and cardiovascular complications than those without it. Patients with B^*2705 and B^*2702 are associated with early-onset hip ankylosis and enteritis, B^*2704 is linked to vision impairment and cardiovascular disease, and B^*2715 has a higher association with uveitis. Therefore, understanding the characteristics of different subtypes of clinical phenotypes is of great significance as a guide to the diagnosis and treatment of SpA.
- Spondyloarthritis /
- HLA-B^*27 subtype /
- Clinical phenotype /
- Correlation

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表 1 脊柱关节炎中常见的HLA-B^*27亚型

Table 1. Common HLA-B*27 subtypes in spondyloarthritis

疾病	主要相关亚型
强直性脊柱炎	B^2704、B^2705、B^2702、B^2707、B^2703、B^2708、B^2710、B^2715
反应性关节炎	B^2705、B^2704、B^2707、B^2702、B^*2710
银屑病关节炎	B^2704、B^2705、B^*2702
未分化脊柱关节炎	B^2705、B^2704、B^2707、B^2708、B^*2710
炎症性肠病性关节炎	暂缺

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