HLA antigens in psoriatic arthritis subtypes of a Spanish population.
ABSTRACT HLA-A, B, and C antigens were studied in 104 Spanish patients with psoriatic arthritis. Different clinical features were evaluated and the patients divided into disease subsets. HLA-B17, B27, B16, and Cw6 were the most common haplotypes in the total group. The HLA-B17/Cw6 haplotype was increased in patients with oligoarthritis. The increase of antigen B17 correlated with oligoarthritis and spondarthritis, whereas Cw6 was more significant in oligoarthritis. The prevalence of the B27/Cw1 haplotype was greater in association with spondarthritis and was probably related to the B27.5 subtype linked to Cw1. A significant negative association between the B44/Cw5 haplotype and psoriatic arthritis was found. The existence of several haplotypic factors in the different subsets is discussed. Lack of one or more HLA factors is thought to be responsible for the different clinical forms of psoriatic arthritis.
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ABSTRACT: Frequencies of recently described HLA-A,-B (antigens or splits) and HLA-C and HLA-DR antigens are studied in a 450 normal Spaniards sample. The linkage disequilibria are also calculated. HLA-DR7 is more frequent than in any other population studied. Aw30-B18 and Aw33-B14 associations are common and specific Spanish, Basque, and Sardinian HLA features. A11-B17 association is found in our Spanish sample and also in Basques. HLA-Bw4,-Bw6 antigens are analyzed by family mating and segregation and also using unrelated individuals. It shows a good fit as a genetic system. HLA-B antigens are included either in Bw4 or Bw6 according to expectations from other Caucasoid population results. The possibility of a common and North African origin (Iberians) for Spaniards, Basques, and Sardinians is discussed on the basis of presently available HLA data.Human Genetics 02/1981; 58(3):344-8. · 4.63 Impact Factor
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ABSTRACT: 51 psoriasis vulgaris patients and 93 controls were tested for HLA-A,B,C and DR antigenic frequencies. Significant increases of B17, Cw6 and DR7 were documented in the patient group, as well as a decreased frequency of DR1. The significance of these findings is discussed. DR7 occurred more often together with Cw6 in psoriasis patients than in controls, which might suggest that there are at least two interacting HLA linked genes which increase the disease susceptibility and possibly one DR1 linked gene associated with resistence to the disease.Tissue Antigens 04/1981; 17(5):525 - 529. · 2.93 Impact Factor
Article: HLA antigens in psoriatic arthritis.[show abstract] [hide abstract]
ABSTRACT: HLA antigen frequencies were studied in 158 patients with psoriatic arthritis, and compared to those of 101 patients with uncomplicated psoriasis and 243 healthy controls. The HLA antigens B16, B17, B27, B39 and Cw6 were associated with psoriatic arthritis. No associations between DR antigens and psoriatic arthritis were demonstrated. However, the subset of patients with rheumatoid-like arthritis demonstrated an increase in DR4. Uncomplicated psoriasis patients had higher frequencies of B17, Cw6 and DR7 than patients with psoriatic arthritis, while B7 and B27 correlated with development of arthritis. HLA-B27, Cw2 and DRw52 were associated with back involvement, whereas B38 and B39 were associated with polyarthritis. HLA-B7, B13 and DR7 correlated with milder disease in patients with psoriatic arthritis.The Journal of Rheumatology 07/1986; 13(3):586-92. · 3.26 Impact Factor
Annals ofthe Rheumatic Diseases 1990; 49: 318-319
HLA antigens in psoriatic arthritis subtypes of a
J C Torre Alonso, A Rodriguez Perez, Eliecer Coto
HLA-A, B, and C antigens were studied in 104
Spanish patients with psoriatic arthritis. Dif-
ferent clinical features were evaluated and the
patients divided into disease subsets. HLA-
B17, B27, B16, and Cw6 were the most
common haplotypes in the total group. The
HLA-B17/Cw6 haplotype was increased in
patients with oligoarthritis. The increase of
antigen B17 correlated with oligoarthritis and
spondarthritis, whereas Cw6 was more signi-
ficant in oligoarthritis. The prevalence of the
B27/Cwl haplotype was greater in association
with spondarthritis and was probably related
to the B27.5 subtype linked to Cwl. A signifi-
cantnegative association betweentheB44/Cw5
haplotype and psoriatic arthritis was found.
The existence of several haplotypic factors in
the different subsets is discussed. Lack of one
or more HLA factors is thought to be respon-
sible forthe different clinicalforms ofpsoriatic
between susceptibility of psoriatic arthritis and
HLA-B17, B13, B27, B37 antigens."'
antigen association seems to be secondary to the
stronger Cw6 association.5 Studies of different
families have shown that the HLA genetic
factor plays a major part in the development of
psoriatic arthritis,6 7 but its mode of inheritance
is at present unclear.8 Different HLA class I
antigens may be linked to psoriatic arthritis
susceptibility in different populations, but the
relation between HLA antigens and clinical
subsets of psoriatic
sufficiently investigated. The aim of this study
was to map susceptibility genes within the HLA
in a large sample of Spanish subjects with
psoriatic arthritis using available HLA markers,
and to correlate the prevalence of these markers
with subsets of different clinical features.
studies have found
HLA-A, B, and C typing was carried out by a
standard microlymphocytotoxicity technique on
peripheral lymphocytes.9 Local and 9th HLA
Workshop antisera were used.
Data were analysed by a computer program.
When the antigen prevalences deviated signifi-
cantly from those of normal subjects the corres-
ponding p values were multiplied by the number
of antigens, which were only considered when
there were more than 20. The x2 test was used to
compare the prevalences of HLA antigens, and
Yates's correction was applied. Relative risk
(RR) was also calculated according to Sveigaard
Table 1 lists the prevalences of HLA-A, B, and
C antigens in 104 patients with psoriatic arthritis
and in the controls. Significant association was
found between psoriatic arthritis and HLA-
B17, B27, B16 (table
results.2 3 HLA-B17, which
1), which confirmed
Table 1: Prevalence of relevant HLA antigens in 104
northern Spanish patients and in controls
NS Covadonga, Oviedo,
Reunato lgia, Hospital
NS Covadong, Oviedo,
J C Toffe Alonso
A Rodriguez Perez
Inmunologia, Hospital NS
Covadonga, cNVillamil s/n,
33006 Oviedo, Spain.
Accepted for publication
10 July 1989
Patients and methods
HLA-A, B, and C antigens were studied in 104
unrelated patients with psoriatic arthritis. The
diagnostic critena used were those established
by Moll and Wright.7 Healthy volunteers (109)
from a sample of the Spanish population served
as controls. Several clinical features were evalu-
ated and the patients divided into disease
subsets: 36 had oligoarthritis, 30 polyarthritis,
spondarthritis. Moreover, five had
arthritis mutilans and five the distal form with
involvement of the distal interphalangeal joint.
Table 2: HLA antigens in psoriatic arthritis subsets. Values
are shmon as the percentage ofpatients in each subset
possesstng a partiular antigen with relative nsk in
*p<0-05; **p<0-025; ***p<0-01; ****p<0-005.
HLA antigens inpsoriatic arthritis
linkage disequilibrium with Cw6,2A was signi-
Additionally, B44, Cw4, and CwS were de-
creased, though not significantly, in psoriatic
arthritis. When different groups were analysed
(table 2) the antigen B17 was relevant in both
oligoarthritis (RR=5-9; p<0 05) and spond-
arthritis (RR=6-6; p<0 05). The antigen Cw6
had an important relative risk only in oligo-
arthritis (RR= 10; p<0-01); it was absent in
spondarthritis.In contrast, B27 was more
prevalent in patients with spondarthritis (RR=
38-8; p<0005). The increase in the Cwl
antigen in spondarthritis wasprobablysecondary
to the noted B27 association (RR=5-4; p<0 05).
Correlation was found between B7, B37 and the
polyarticular form (table 2).
Several studies have sought an association
between susceptibility to psoriatic arthritis and
the HLA antigens. Psoriatic arthritis has been
reported to be associated with HLA-B17, B37,
B13, and Cw6.2A Our study was performed in
a large group of Spanish patients with psoriatic
arthritis. The results are in agreement with
those found byotherauthors in Caucasoids.
The B17 antigen is related to oligoarthritis and
spondarthritis subsets in the Spanish population.
Cw6 is more strongly associated with oligo-
arthritis than with polyarthritis. These findings
have not been described previously. It has been
noted, however, that the B17/Cw6 haplotype in
Caucasoids is weakly maintained in the Spanish
population.9 These facts support the idea that
B17 and Cw6 might act as independent genetic
factors of susceptibility, resulting in different
clinicalmanifestations. Nevertheless, therelative
risk in oligoarthritis is higher for patients with
B17/Cw6 than for those with B17 alone. Several
closely linked factors promoting susceptibility
to psoriatic arthritis may exist within an HLA
haplotype (B17/Cw6). All may be necessary for
the occurrence of oligoarthritis. Lack of one or
more factors (B17 in polyarthritis, Cw6 in
spondarthritis) might lead to the different clini-
cal forms. In patients tested B27 is increased
and correlates with a spondarthritis subset. The
Cwl association found with psoriatic arthritis is
secondary to B27. Several studies show the
existence ofat least seven B27 subtypes.12 13 An
interesting question is whether the association
of B27 with psoriatic arthritis involves just one
B27 subtype. HLA-B27
is in linkage dis-
equilibrium with Cwl and Cw2 in Caucasoids. 13
The HLA-B27.5 subtype is in linkage dis-
equilibrium with both Cwl and Cw2. On the
other hand, B27.2 is almost exclusively linked
to Cw2. The results (increase of B27/Cwl in
spondarthritis) suggest that B27.5 is probably
analysis by isoelectric focusing
needed for confirmation of this. This result
contrasts with the Cw2 increase described by
Gladman et al, which is probably secondarily
associated with both B27.2 and B27.5 subtypes
in American patients.3 The association of B37
and B13 with psoriatic arthritis seems to be
secondary to the stronger Cw6 association. The
negative association of the B44/Cw5 haplotype
has not been previously reported and may have
a protective role against the development of
These findings further support the hypothesis
that psoriatic arthritis is a heterogeneous dis-
order. Several closely linked psoriatic arthritis
susceptibility factors may exist within an HLA
haplotype. Their presence may be necessary for
the development of psoriatic arthritis. Absence
ofone or several HLA susceptibility factors may
lead to the development of different clinical
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