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
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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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