HLA class I and II alleles in susceptibility to ankylosing spondylitis

Objective To examine associations of HLA class I and class II alleles with ankylosing spondylitis (AS) in three cohorts of patients of European, Asian and African ancestry. Methods HLA-A, HLA-B, HLA-C, HLA-DRB1, HLA-DQB1 and HLA-DPB1 alleles were genotyped in 1948 unrelated white and 67 African-American patients with AS from the Prospective Study of Outcomes in Ankylosing Spondylitis cohort, the North American Spondylitis Consortium and Australo-Anglo-American Spondyloarthritis Consortium, 990 white and 245 African-American Controls and HLA-B alleles in 442 Han Chinese patients with AS and 346 controls from Shanghai and Gansu, China. In addition to the case: control analyses, HLA-B(star)27-negative patients with AS were analysed separately, and logistic regression and ' relative predispositional effects' (RPE) analyses were carried out to control for the major effect of HLA-B(star)27 on disease susceptibility. Results A lthough numerous associations were seen between HLA alleles and AS in whites, among HLA-B(star)27-negative patients with AS, positive associations were seen with HLA-A(star)29, B(star)38, B(star)49, B(star)52, DRB1(star)11 and DPB1(star)03:01 and negative associations with HLA-B(star)07, HLA-B(star)57, HLA-DRB1(star)15:01, HLA-DQB1(star)02:01 and HLA-DQB1(star)06:02. Additional associations with HLA-B(star)14 and B(star)40 (B60) were observed via RPE analysis, which excludes the HLA-B(star)27 alleles. The increased frequency of HLA-B(star)40:01 and decreased frequency of HLA-B(star)07 was also seen in Han Chinese and African-Americans with AS. HLA-B(star)08 was decreased in whites with acute anterior uveitis. Conclusions These data, analysing the largest number of patients with AS examined to date in three ethnic groups, confirm that other HLA class I and II alleles other than HLA-B(star)27 to be operative in AS predisposition.