Ankilozan Spondilit Ön Tanılı Hastalarda HLA-B27 Sıklığı

Abstract

Amaç: Ankilozan spondilitin (AS) oluşumunda genetik faktörlerin önemli olduğu kabul edilmiştir. Hastalığın patogenezinde rol alan en önemli genetik faktörlerden birinin insan lökosit antijen (HLA)-B27 olduğu bilinmektedir. Bu çalışmada AS ön tanılı hastalarda HLA-B27 sıklığının tespit edilmesi ve hastaların demografik ve laboratuvar bulguları ile HLA-B27 arasındaki ilişkinin karşılaştırılması amaçlandı.

Materyal-Metod: AS ön tanılı 64’ü erkek, 91’i kadın olmak üzere toplam 155 hasta çalışmaya dahil edildi. Hastaların poliklinik takip dosyaları geriye dönük taranarak demografik özellikleri, genetik soyağacı bilgileri, laboratuvar bulguları ve HLA-B27 gen analizi sonuçları kaydedildi. Hastaların HLA-B27 analizleri Real-Time PCR yöntemi ile yapıldı.

Bulgular: Elde edilen bulgulara göre çalışmaya alınan AS ön tanılı hastaların 31’inde (%20) HLA-B27’nin pozitif olduğu saptandı. Erkeklerde HLA-B27 pozitifliği daha yüksekti (p=0,010). Yaş ortalaması cinsiyetler arasında fark göstermedi (p>0,05). HLA-B27 pozitif olanların yaş ortalaması negatif olanlara kıyasla anlamlı derecede düşüktü (p=0,047). Serum CRP ve sedimentasyon seviyeleri HLA-B27 pozitifliğinde belirleyici değildi (p>0,05). HLA-B27 pozitif olan hastalarda aile öyküsü olanlar olmayanlara kıyasla daha fazlaydı (p=0,000).

Sonuç: AS semptomlarını taşıyan hastalarda HLA-B27 pozitiflik oranı literatürden farklı olarak düşük bulundu. Bu farklılığın, AS ön tanılı hastaların çalışmaya dahil edilmesi, farklı hasta popülasyonu, klinik varyasyonlar, farklı etnik köken ve farklı genetik ve/veya çevresel faktörlerden kaynaklanmış olabileceğini düşünmekteyiz. Toplumumuzda AS hastalarında HLA-B27 frekansını daha net ortaya koyabilmek için kesin tanı almış daha geniş hasta popülasyonunda çalışmalara ihtiyaç vardır. 

Keywords

• Ankilozan spondilit
• HLA-B27
• sedimentasyon
• CRP

Frequency of HLA-B27 in Patients with Pre-Diagnosis of Ankylosing Spondylitis

Abstract

Objectives: Genetic factors have been acknowledged as crucial in ankylosing spondylitis (AS) genesis. Human leukocyte antigen (HLA)-B27 known to play a role in the pathogenesis of the disease. In this study, it was aimed to determine the frequency of HLA-B27 in patients with pre-diagnosis of AS and to compare the relationship between demographic and laboratory findings and HLA-B27.

Material-Method: A total of 155 patients, 64 male and 91 female, with pre-diagnosis of AS were included in the study. Demographic characteristics, pedigree information, laboratory findings and HLA-B27 gene analysis results were recorded from the policlinic files of the patients. HLA-B27 analyzes were performed by Real-Time PCR method.

Results: HLA-B27 positivity was detected in 31 (20%) of AS patients. HLA-B27 positivity was higher in men (p=0.010). The mean age did not differ between the genders (p>0.05). The mean age of those who were HLA-B27 positive was significantly lower than those who were negative (p=0.047). Serum CRP and sedimentation levels were not determinative in HLA-B27 positivity (p>0.05). It was more common in HLA-B27 positive patients than those without family history (p=0.000).

Conclusion: The HLA-B27 positivity rate was found to be low in patients with AS symptoms. We suggest that this difference may be due to the inclusion of patients with pre-diagnosis of AS, different patient population, clinical variations, different ethnic origin and different genetic and/or environmental factors. In order to more clearly reveal the HLA-B27 frequency in AS patients, studies with a larger patient population are needed.

Keywords

• Ankylosing spondylitis
• HLA-B27
• sedimentation
• CRP

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