Molecular mimicry in HLA-B27-related arthritis

Ann Intern Med. 1989 Oct 1;111(7):581-91. doi: 10.7326/0003-4819-111-7-581.

Abstract

A unique feature of patients with ankylosing spondylitis and reactive arthritis is that almost all share the HLA type B27. The primary structures of the HLA-B27 antigens have been determined. At least six variants exist. However, disease predisposition does not appear to be restricted to a particular variant. One hypothesis about the pathogenesis of arthritis is that the bacteria that cause the arthritis carry components that are cross-reactive with HLA-B27 antigens. Several reactive bacterial components have indeed been identified using monoclonal anti-HLA-B27 antibodies. Even more striking is the identification, through a computerized search, of a Klebsiella protein. This protein carries a stretch of six amino acids identical to residues 72 to 77 of two of the HLA-B27 variants. A synthetic peptide carrying these six amino acids of HLA-B27 protein is reactive with serum antibodies in some patients with arthritis. With this knowledge, investigators will be able to formulate new approaches for examining the pathogenesis of HLA-B27-associated arthritis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Alleles
  • Arthritis / etiology
  • Arthritis / immunology*
  • Bacteria / immunology
  • Bacterial Infections / complications
  • Cross Reactions
  • Disease Susceptibility / immunology
  • HLA-B Antigens / analysis*
  • HLA-B Antigens / genetics
  • HLA-B Antigens / immunology
  • HLA-B27 Antigen
  • Humans
  • Spondylitis, Ankylosing / immunology

Substances

  • HLA-B Antigens
  • HLA-B27 Antigen