HUMAN LEUKOCYTE ANTIGEN-B27 AND DISEASE SUSCEPTIBILITY IN VOJVODINA, SERBIA
Vojvodić S1,*, Ademović-Sazdanić D1, Busarčević I2
*Corresponding Author: Assistant Professor Svetlana Vojvodić, M.D., Ph.D., Department for Laboratory Testing, Tissue Typing Compartment, Institute for Blood Transfusion of Vojvodina, Hajduk Veljkova 9a, 21000 Novi Sad, Serbia; Tel.: +381-21-4877-963; Mobile: +381-64-861-58-12; Fax: +381-21-4877-978; E-mail: ssvu@EUnet.rs
page: 55

DISCUSSION

The genetic susceptibility of a population to a particular disease can be known through the study of HLA genetics. As the genes come from parental segregation, genetic screening can predict the risk of development of the disease, and the disease can be detected before onset or at a very early stage [4,9,19,20]. It has now been 35 years since the association of HLA-B27 and AS has been demonstrated. Over 90.0% of patients with AS express the HLAB27 antigen, but only 1.0-6.0% of HLA-B27 positive individuals in the general population develop AS [4,19]. In contrast, in families with AS, the prevalence is 10.0-30.0% in adult first-degree relatives inheriting HLA-B27. The concordance in identical twins is approximately 65.0%. It is currently believed that susceptibility to AS is determined almost entirely by genetic factors, with HLA-B27 comprising about one-third of the genetic component [3,21,22]. In the present study we have demonstrated for the first time the distribution of HLA-B27 in SpA patients of Vojvodina ethnicity. For the whole SpA group, we have found 19 of 97 patients to be HLA-B27 positive (19.58%). The highest frequency of HLA-B27 (62.5%) was observed in AS patients, following with the 33.3% in both of groups of patients with psoriatic arthritis as well as rheumatoid arthritis, respectively. Acute anterior uveitis and synovitis coxae patients revealed lower frequencies of the investigated marker, 18.1 and 12.5%, respectively. In the group of patients with lumboihialgia and polyarthralgia, there were 7.1 and 5.8% HLA-B27 positive patients. In the control group of healthy subjests from Vojvodina, the HLA- B27 marker was detected in 14 of 224 individuals (6.2%). In the AS group, our findings in the present study corroborate other studies, which point to a strong association between HLA-B27 and AS [2,8,23,24]. The distribution of HLA-B27 in our sample of AS patients from Vojvodina is similar from that found in populations of Tunisia, (62.0%), Italy (76.0-68.0%) and Turkey (70.0%) [2,21]. In contrast, the HLA-B27 frequency in AS patients from Vojvodina was lower than that reported from different European countries: Spain-Galicia (94.3%), United Kingdom (90.2-94.0%), Norway (north) (93.0%), Finland (93.0%), Hungary (92.7%), Bulgaria (88.0%), Spain (84.4%), Germany (82.0%) and Romania (72.1%) [2]. Since the number of our RA and PA patients was small, the HLA-B27 frequency (33.3%) as well as (RR =7.5 and EF =0.288), values we found may not reflect the real situation, as implied also by the suboptimal statistical power of this part of the study. However, as described in previous studies, HLA-B27 is detected with 5-10 times greater frequency in RA patients than in the general population [2,25,26], and the frequency of this marker in our study compared to reports of some studies, was similar [2,27]. Also, the HLA-B27 frequency in the investigated patients with PA we found in our study was higher than that reported from Ireland (15.0%), continental Italy (12.4%) and central Serbia (7.0%) [2,27], but closer to the frequencies reported from the United Kingdom (26.0%) and Spain (22.0%) [2,28]. In the AAU group, the HLA-B27 frequency in our Vojvodina sample was higher than that reported for the Tunisian patients (4.4%) [29] and Asia (6.0- 13.0%), but lower than that reported for western countries (18.0- 32.0%) [30,31] and Indian population (56.2%) [32]. Although, there was a statistical difference in HLA-B27 frequency in the subgroup of patients with synovitis coxae in comparison to controls and RR was 2.142, there is no positive association of synovitis coxae and HLA-B27 antigen in the population of Vojvodina (EF = 0.0671). In other investigated subgroups of patients, such as for patients with lumboishialgia and acute anterior uveitis, RR was higher than 1, but there is no positive association with HLAB27 since EF were 0.0094 and 0.1260, respectively.



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