3 years ago

The Association between HLA Genetic Susceptibility Markers and Sonographic Enthesitis in Psoriatic Arthritis

Richard Cook, Vinod Chandran, Dafna Gladman, Lihi Eder, Ari Polachek, Fatima Abji
Objective Enthesitis is an important pathophysiologic component in psoriatic arthritis (PsA). Human Leukocyte Antigen (HLA) genes are implicated in the pathogenesis of PsA. Little is known about the relation between HLA genetic susceptibility markers and enthesitis in PsA patients. Our aim was to examine the association between HLA genetic susceptibility markers and sonographic enthesitis in PsA. Methods A cross-sectional analysis was conducted in patients with PsA. Sonographic enthesitis was assessed according to the MAdrid Sonography Enthesitis Index (MASEI) scoring system. HLA genotyping was performed using sequence-specific oligonucleotide probes. The association between 6 HLA susceptibility markers of PsA and the severity of sonographic enthesitis was assessed using multivariable regression models adjusted for age, sex, BMI and disease duration. Results Two hundred and twenty-five patients were included, 57% male with mean (s.d.) age of 55.8 (12.9) years and PsA duration of 16.4 (12.3) years. In the multivariable regression model HLA-B*27 (β 4.24, 95% CI 0.02, 8.46) was associated with a higher enthesitis score and the interaction between HLA-B*27 and PsA duration was statistically significant, showing an increasing effect of HLA-B*27 with longer PsA duration (β 4.62, 95% CI 1.38, 7.86). Conclusion HLA-B*27 is associated with more severe sonographic enthesitis in PsA, particularly in patients with longer disease duration. This finding highlights the possible role of genetic variants in predisposing to PsA subphenotypes. This article is protected by copyright. All rights reserved.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1002/art.40423

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