Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P01889 (ankylosing spondylitis)
 5,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Seronegative arthritis is part of a multifactorial syndrome which also includes acute anterior uveitis (AAU), psoriasis, inflammatory bowel disease and forms of A-V block and aortic incompetence. The whole syndrome may be referred to as HEreditary Multifocal Relapsing Inflammation (HEMRI). Any sign may occur alone or in combinations with others. The signs may be triggered by infections, the arthritic components are then referred to as reactive arthritis. Genetic factors predetermine who is to contract disease when triggered. HLA-B27 itself is probably of major significance in ankylosing spondylitis and AAU. A genetic factor in linkage disequilibrium with HLA B13 and B17 is instrumental in familial psoriasis. Other genetic factors may determine psoriatic arthritis, and possibly also inflammatory bowel disease and juvenile arthritis. The genetic factors interact with each other and with the environmental factors when producing disease. Diagnosis should be based on demonstrated signs of disease. Classification according to genetic factors reflects etiology, disease manifestations and prognosis.
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PMID:Seronegative arthritis--etiology and diagnosis. 333 Feb 95

To assess the chronicity of symptoms and long term prospects for employment in patients with Reiter's syndrome, a follow-up study of 111 patients was performed. Ninety-eight patients were available for follow-up; these had a mean disease duration of 7.9 years (range two months to 39 years). At follow-up, 55 patients had symptomatic joints and 26 objective evidence of synovitis, but only seven had chronic joint deformity. Seven patients fulfilled criteria for ankylosing spondylitis. Ninety-three patients were in functional class I or II, 86 patients were working, 26 had changed employment, and 11 were unemployed because of the disease. No prognostic features of value were identified. The tissue antigen HLA B27 was associated significantly with anterior uveitis and radiological sacroiliitis.
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PMID:Reiter's syndrome: chronicity of symptoms and employment. 346 89

We have previously reported the association of Chlamydia trachomatis with HLA B27+ related diseases. To investigate the possibility that chlamydial antibodies serve to localize the immune response in such diseases, we examined the crossreactivity of chlamydial antibodies (rabbit anti-D and anti-L2 serotypes) with peripheral blood mononuclear cells of patients with ankylosing spondylitis (AS) and anterior uveitis (AU) and with human and bovine ocular tissue and cells in culture. Our results indicate a significantly increased percentage binding of chlamydial antibody (D serotype) to the mononuclear cells of HLA B27+ patients with AS when compared with HLA B27- patients with AS (12.9% +/- 2.2 versus 5.4% +/- 2.2), B27+ controls (5.5% +/- 1.5) and B27- controls (6.1% +/- 1.0). There was no significant difference between controls and HLA B27+ patients with AU (6.6% +/- 1.9) and B27- patients with AU (8.7% +/- 1.1). This crossreactivity could not be blocked by monoclonal HLA B27 antibody. Chlamydial antibodies (D and L2) crossreact with human and bovine conjunctiva but not uvea, tissue culture derived iris fibroblasts or smooth muscle cells. Our results provide additional support for the concept of crossreactivity between antibodies to microbial agents and peripheral blood mononuclear cells of patients with HLA B27+ AS.
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PMID:Chlamydial antibody crossreactivity with peripheral blood mononuclear cells of patients with ankylosing spondylitis: the role of HLA B27. 348 86

To test the pathogenetic role of the phenotype MZ of alpha 1-antitrypsin/alpha 1-protease inhibitor (PI) in acute anterior uveitis (AAU) and in different rheumatic diseases we examined 360 unrelated patients including 93 with AAU alone, 24 patients with AAU and ankylosing spondylitis (AS), 21 patients with AAU and Reiter's disease (RD), 26 patients with AAU, AS, and RD 54 patients with AS alone, 16 patients with RD alone, 115 patients with rheumatoid arthritis (RA) alone, and 11 patients with psoriatic arthritis (PA) alone. Of the 164 AAU patients, 80 had a single attack, and 84 had repeated episodes. There were neither significant differences between different groups of the patients and 120 healthy controls nor between patients with AAU alone and patients with AAU and AS or RD in the frequencies of the PI phenotypes tested. The results indicate that the PI MZ type is not closely associated with AAU, AS, RD, RA and PA and that it does not play any role in determining whether AAU shows a pattern of a single attack or repeated episodes, and whether AAU occurs alone or together with AS or RD.
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PMID:Alpha 1-antitrypsin in acute anterior uveitis and rheumatic diseases. 349 56

We studied the clinical features and prognosis of 73 patients with HLA-B27 positive and 71 patients with HLA-B27 negative acute anterior uveitis using computer analysis of more than 50 variables per patient. The patients with HLA-B27 positive acute anterior uveitis showed the following characteristics which were significantly different from patients with HLA-B27 negative acute anterior uveitis: younger age at onset; high male to female ratio; frequent unilateral alternating eye involvement; severe ocular symptoms during activity, such as presence of fibrin in the anterior chamber; absence of mutton fat keratic precipitates; high incidence of ocular complications; and frequent association with seronegative spondyloarthropathies. Despite the difference of disease severity and incidence of complications, the long-term visual outcome did not differ significantly between the two groups. No distinctions were observed when patients with HLA-B27 positive acute anterior uveitis were subdivided according to sex or the presence of ankylosing spondylitis. HLA-B27 positive acute anterior uveitis formed a distinct clinical entity associated with serious prognosis as compared to HLA-B27 negative acute anterior uveitis.
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PMID:Clinical features of acute anterior uveitis. 349 16

Genetic factors other than HLA-B27 may play a role in the pathogenesis of ankylosing spondylitis (AS), acute anterior uveitis (AAU) and Reiter's syndrome (RS). Studies by Brewerton et al. and Kijlstra et al. showed associations between the MZ phenotype of alpha 1-antitrypsin and the Gm phenotype zafngb of IgG in patients with AAU, who developed AS. The loci for alpha 1-antitrypsin (PI) and Gm allotypes (IGH) are situated on the tip of the long arm of chromosome 14. In the present study we tried to clarify and extend the above studies. In 41 B27+ AAU patients with AS the alpha 1-antitrypsin and Gm phenotype and allotype frequencies were not statistically different from those in B27+ AS patients developing AAU and in B27+ AAU patients without AS, in B27+ AS patients without AAU, B27+ patients with Reiter's syndrome, B27+ patients with low back pain, B27- AAU patients and normal controls. It is therefore unlikely that genes on the tip of chromosome 14 play a role in the pathogenesis of B27 associated diseases. A hypothesis was formed suggesting that a bacterial-derived modifying factor may replace the position of beta 2 microglobulin in the HLA-B27 molecule resulting in an impaired cytotoxic T cell reactivity.
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PMID:Genes on chromosome 14q and their role in the pathogenesis of HLA-B27 associated diseases. 349 3

Enteric infections with Gram-negative bacteria are thought to play an important part in HLA-B27-associated disease such as Reiter's syndrome and reactive arthritis. But the role of bacterial infections in HLA-B27-positive ankylosing spondylitis (AS) and acute anterior uveitis (AU) is still controversial. A special interest has recently been devoted to the role of klebsiella infection in HLA-B27-associated disease. We studied the humoral immune response against a 'cross-reactive' strain of Klebsiella pneumoniae in 62 patients with anterior uveitis and 33 healthy controls. The anterior uveitis patients were subdivided into 25 HLA-B27-negative patients without AS (B27- AU+ AS-), 17 HLA-B27-positive patients without ankylosing spondylitis (B27+ AU+ AS-), and 19 HLA-B27-positive patients with ankylosing spondylitis (B27+ AU+ AS+). Total serum IgA was higher in patients than in controls in both the B27+ AU+ AS+ and B27+ AU+ AS- patients but not in the B27- AU+ AS- group. No abnormalities were observed in the total serum IgG levels. The level of both the IgG and IgA klebsiella antibodies did not differ in the various patient groups tested as compared with the controls. Comparisons between the patient groups showed that the IgG anti-klebsiella response was higher in B27-positive patients patients without AS than in those with AS. These results suggest that stimulation of mucosal surfaces may play a role in HLA-B27-associated anterior uveitis. Whether klebsiella organisms are involved in this stimulation remains unclear.
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PMID:IgG and IgA immune response against klebsiella in HLA-B27-associated anterior uveitis. 351 61

Over a five-year period 245 patients with uveitis were investigated at the Uveitis Clinic, Sydney Eye Hospital, for possible aetiological and relevant disease associations. Uveitis was anterior in 75% of patients, posterior in 21% and generalized in 4%. Anterior uveitis (AU) was idiopathic in 52% of cases. In patients tested for the HLA-B27 antigen, 47% were HLA-B27 positive, including all cases of ankylosing spondylitis (8% of cases) and Reiter's syndrome (3% of cases). There was a marked male predominance in patients with AU, especially in HLA-B27 positive individuals. Posterior uveitis (PU) was most frequently unilateral, chronic and idiopathic (24% of cases), whilst recognizable aetiologies included toxoplasmosis (20%), Behcet's syndrome (14%), sarcoidosis (12%) and pars planitis (12%). The peak age of onset in patients presenting with AU was 30 to 40 years, whilst patients with PU presented a decade earlier. There were no major differences between males and females in the age of onset of their uveitis.
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PMID:Uveitis: aetiology and disease associations in an Australian population. 376 71

In 40 patients with ankylosing spondylitis (AS) no evidence for IgA nephropathy was obtained. This conclusion was based on the absence of hematuria and on the inability to find an increased incidence of IgA-containing immunoglobulin deposits in skin biopsies. Increased Clq binding assay was only found in those AS patients with anterior uveitis. In 26% of the skin biopsies perivascular mononuclear cell infiltrates were observed, and immunoglobulin deposits were seen in 65%. These facts suggest that the immunologic system is involved in the pathogenesis of this disease.
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PMID:Absence of IgA nephropathy in patients with ankylosing spondylitis. 378 89

Six patients with severe, refractory anterior uveitis (AU) were treated with intermittent, intravenous pulses of methylprednisolone (MP). Five patients had bilateral AU and all had decreased visual acuities. AU was idiopathic in four subjects, one male had ankylosing spondylitis (HLA-B27 +) and one female had juvenile polyarthritis. All patients were initially treated with 1 g of MP intravenously (IV) on alternate days during the first week. Subsequently, patients received weekly injections of MP on a reducing dosage regime to a maintenance dose of 125 mg IV weekly. This therapy produced a rapid resolution of the signs of uveal inflammation and improved visual acuity. Two patients have been maintained on this treatment regime for over 12 months without evidence of disease relapse or serious drug side effect. Pulse MP is effective in the treatment of severe anterior uveitis and may be a useful adjunct in the management of patients with uveitis.
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PMID:Methylprednisolone pulse therapy in severe anterior uveitis. 383


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