The mystery of HLA-B27: if it isn't one thing, it's another.

摘要

Thirty-four years have elapsed since the discovery of the striking prevalence of HLA-B27 in patients with ankylosing spondylitis (AS) (1). During this time, great progress has been made in the classification, diagnosis, and treatment of AS and related spondylar-thritides, and a vast literature on the epidemiology, genetics, biochemistry, and immunology of HLA-B27 has emerged. Despite these developments, however, the molecular basis of the association of AS with B27 remains unknown. Although the therapeutic revolution wrought by the introduction of anti-tumor necrosis factor (anti-TNF) agents has demonstrated that progress in the treatment of spondylarthritis is not necessarily dependent upon detailed understanding of disease pathogenesis, it still seems likely that elucidation of the molecular role of B27 in AS would lead to further substantial improvements in the management of this and related disorders, and perhaps even to their prevention.