Valor diagnóstico del HLA-B27 en las espondiloartropatías

Spondyloarthropathies are chronic inflammatory diseases that share a wide range of clinical features, including spondylitis, sacroiliitis, pauciarticular peripheral arthritis, and enthesopathy. The pathogenesis is not well known, although all these diseases (ankylosing spondylitis, reactive arthritis, psoriatic arthritis, arthritis in patients with inflammatory bowel disease, some forms of juvenile idiopathic arthritis, and undifferentiated spondyloarthropathies) seem to have common genetic bases. In the last few years, several theories on the pathogenesis of these diseases have been postulated. Many of these theories have implicated HLAB27, a molecule of the major histocompatibility complex, as a predisposing genetic factor. However, because some B27-positive individuals are disease-free while some B27 negative individuals develop one of these diseases, the pathogenic role of HLA-B27 remains unclear. To date, the diagnosis of spondyloarthropathies has mainly been based on clinical and radiographic criteria (New York modified criteria, European Study Group criteria, Bernard Amor criteria). The present review aims to describe current knowledge on the value of HLA-B27 in the diagnosis of spondyloarthropathies.