BACKGROUND: HLA-B27 typing has long been performed by the microlymphocytotoxicity method(MCT) but the flow cytometry method(FCM) was introduced several years ago. False positive results due to the HLA-B7 cross reactive groups(CREG) were the main drawback of the serologic method. The authors performed polymerase chain reaction-sequence specific primer(PCR-SSP) test for HLA-B27 to compare the results with serologic methods. METHODS: PCR-SSP test for HLA-B27 was performed on four hundred forty one samples. Three hundred twenty eight samples were tested by MCT and one hundred thirteen samples by FCM. PCR-SSP for HLA-B27 subtyping or Amplification Refractory Mutation System-PCR(ARMS-PCR) for HLA-B typing was performed on twenty four discrepant samples. RESULTS: The concordance rate between MCT and PCR-SSP was 92.9%(305/328) and the concordance rate between FCM and PCR-SSP was 99.1%(112/113). Twenty four(5.4%) out of four hundred forty one samples showed discrepancy between serologic methods and PCR-SSP method. Fourteen out of one hundred MCT positive samples and only one out of forty FCM positive samples showed negative by PCR-SSP. Nine samples showed PCR-SSP positive and MCT negative. CONCLUSIONS: The false positive rate of MCT was quite high and there were some false positive and negative results by PCR-SSP, too. From the above findings, we suggest that FCM is the most accurate method for HLA-B27 typing in those laboratory equipped with flow cytometry.
Flow Cytometry* ; HLA-B Antigens ; HLA-B27 Antigen* ; HLA-B7 Antigen

BACKGROUND: The flowcytometric analysis of HLA-B27 gives more objective results and is performed more rapidly than traditional serologic methods. We have used a flowcytometric method using only anti-HLA-B27 monoclonal antibody, but it gave frequently borderline mean fluorescence intensity (MFI) results. The authors compared the method using anti-HLA-B27 antibody (HLA- ABC-m3, Serotec) with the Becton Dickinson (BD) method which uses different HLA-B27 antibody (GS145.2) with CD3 antibody. METHODS: The 59 patients that requested HLA-B27 testing were measured by two methods. In the former method, the mononuclear cells were stained with HLA-B27-FITC and the MFIs were determined in lymphocytes. In the BD method, the whole blood was directly stained with CD3-PE and HLA-B27-FITC. The MFIs were determined in the CD3+ cells, and compared with the MFI of the standard. For the cases showing discrepancy in the two methods or borderline values, the HLA-ABC typing was done. RESULTS: Of 21 showing discrepancy, 10 samples had undergone HLA typing. Among nine samples that were positive by the Serotec method but negative by the BD method, four samples were B7, one B40, one B54 and three B7 CREG negative. One that was negative by the Serotec method but positive by the BD method was confirmed as HLA-B27. CONCLUSIONS: The Serotec method showed significant overlap between the MFIs of HLA-B27 and non B27 samples that resulted in a relatively low efficiency compared with the BD method. The discrepant results of the two methods seem to be due to maily the specificity of the antibody used.
Fluorescence ; Histocompatibility Testing ; HLA-B27 Antigen* ; Humans ; Lymphocytes ; Sensitivity and Specificity

OBJECTIVE: HLA-B27 test require at least 80% of viable cells. So the procedures require immediate processing of the blood samples. To increase the efficiency and the cost-effectiveness of the laboratory, longer maintenance of cell viability is requested. For this purpose, we compared the cell viability of blood samples collected in heparin tubes with those collected in ACD tubes. Our aim was to determine whether the length of storage that could maintain adequate cell viability for HLA-B27 testing depends on the anticoagulants in the storage tube and to ascertain the qualified HLA-B27 results after several days of storage. METHODS: We collected 15 blood samples in ACD and heparin tubes. The samples were stored at 4oC for 6 days and after which, 2 mL of the sample was used to confirm the viability of lymphocytes every 24 hours for 5 days. For evaluating the reproducibility, the HLA-B27 test was performed at the day of sampling and after 6 days of refrigeration. RESULTS: There was no difference in cell viability between ACD and heparin until the sixth day, but a statistically difference was observed from the seventh day (p=0.004). The HLA-B27 test showed no different results even after 6 days of storage. CONCLUSION: We suggest that the heparin tubes have a same storage benefit as the ACD tubes of blood for HLA-B27 testing for less than a week. This can affect more economic and efficient laboratory management for HLA-B27 testing.
Anticoagulants* ; Cell Survival* ; Heparin ; HLA-B27 Antigen* ; Lymphocytes ; Refrigeration

The frequency of HLA-B27 antigen in 24 patients with psoriasis vulgaris and 11 patients with psoriatic arthritis were examined using the standard micro-lympho- cytotoxicity technique. There was a high frequency of HLA-B27 in psoriatic spondylitis with or without peripheral arthritis (83.3%) compared to controls (4.7%) and the relative risk of HLA-B27 for developing psoriatic spondylitis was 82.5% which indicates a strong association between HLA-B27 and psoriatic spondylitis in Korean populations. However, there was no stastical significance observed in the groups of patients with peripheral arthritis alone or psoriasis vulgaris in regard to the frequency of HLA-B27.
Arthritis ; Arthritis, Psoriatic ; HLA-B27 Antigen ; Humans ; Psoriasis* ; Spondylitis

No abstract available.
Arthritis, Psoriatic* ; HLA-B27 Antigen ; Korea* ; Prevalence* ; Psoriasis ; Spondylitis

HLA-B Antigens ; genetics ; HLA-B27 Antigen ; genetics ; Humans ; Spondylitis, Ankylosing ; genetics

A 30-year-old female patient with coexisting ankylosing spondylitis and rheumatoid arthritis was diagnosed and treated. The human leukocyte antigen (HLA)-B27 is a predisposing factor of ankylosing spondylitis and HLA-DR4 is a predisposing factor of rheumatoid arthritis. This patient was HLA-B27 and HLA-DR4 positive, and ankylosing spondylitis manifested before rheumatoid arthritis. After disease modifying anti-rheumatic drugs successfully arrested ankylosing spondylitis activity the patient conceived and delivered a healthy baby. One year later, she developed peripheral polyarthritis and was diagnosed with rheumatoid arthritis. We hypothesized that pregnancy may be one of the environmental factors that can activate rheumatoid arthritis, and that disease modifying anti-rheumatic drugs play an important role in keeping the disease under control.
Adult ; Arthritis, Rheumatoid ; diagnosis ; metabolism ; Female ; HLA-B27 Antigen ; metabolism ; HLA-DR4 Antigen ; metabolism ; Humans ; Spondylitis, Ankylosing ; diagnosis ; metabolism

In order to evaluate association of particular HLA typing with certain uveitis in Korean population, HLA antigens were analyzed in 114 uneitis patients(acute anterior uveitis: 32 cases, Behcet`s disease: 25 cases, intermediate uveitis: 19 cases, Vogt-Koyanagi-Harada (V-K-H) syndrome: 10 cases, retinal vasculitis: 12 cases, Eale`s disease: 3 cases, posterior uveitis: 9 cases, pan.uveitis: 4 cases). The stronger association between acute anterior uveitis and HLA-B27 was statistically significant, and this result was similar to reports in other ethnic groups. Also, the association between V-K-H syndrome and HLA-DR4 showed same results. But the high frequency of HLA-DR7 in the patients with V-K-H syndrome was unque in patients of Korean popjlation and statistically significant. The association between HLA-A2 and posterior uveitis was high in patients of Korean population and statistically significant. Behcet`s disease was stronger association with HLA-B51 but not statistically significant and much weaker association than reports in Japanese group. Although many similarities of associations between particular uveitis and HLA typing were detected as compared with other ethnic groups, distinctive HLA associations were demonstrated in Korean population. Additional cases and long-term follow-up are required to confirm the association with HLA typing and the relationship with prognosis including clinical and laboratory variabilities.
Asian Continental Ancestry Group ; Ethnic Groups ; Follow-Up Studies ; Histocompatibility Testing ; HLA Antigens ; HLA-A2 Antigen ; HLA-B27 Antigen ; HLA-B51 Antigen ; HLA-DR4 Antigen ; HLA-DR7 Antigen ; Humans ; Prognosis ; Retinal Vasculitis ; Uveitis* ; Uveitis, Anterior ; Uveitis, Intermediate ; Uveitis, Posterior

OBJECTIVES: To evaluate the clinical significance of heel pain, a frequently associated enthesopathy in Behcet's disease and to evaluate the association with seronegative spondyloarthropathy. METHODS: 15 Behcet's disease patients diagnosed by International Study Group for Behcet's disease criteria with arthritis were studied prospectively in the period of 1994. 3. 1-1995. 3. 31. Modified New York criteria was adopted for the diagnosis of ankylosing spondylitis. The patients were grouped into two by the presence of heel pain which was documented as tenderness on heel. RESULTS: There were 6 patients in the heel pain group and 9 patients in the non-heel pain group. Clinical characteristics were not significantly different between the two groups. Ankylosing sponaylitis was not associated in either group. ESR was higher with the value of 41.2mm/hr in heel pain group than 25.7mm/hr in non-heel pain group but it was not significant. In heel pam group, one patient showed HLA-B27 positivity, one patient showed erosive bone cha. nge, and one patient showed sacroiliitis but non-heel pain group showed no HLA positivity or bony changes. CONCLUSIONS: We find that subset of Behcet's disease patients with heel pain showed tendency to have higher inflammatory activity, erosive bone change, sacroilitis and HLA B-27 association, thus should be classified as seronegative spondyloarthropathy but seems to be different category from ankylosing spondylitis. These observations should be conducted in a large number of patients to establish the clinical value.
Arthritis ; Diagnosis ; Heel* ; HLA-B27 Antigen ; Humans ; Prospective Studies ; Rheumatic Diseases ; Sacroiliitis ; Spondylarthropathies ; Spondylitis, Ankylosing

BACKGROUND: Routine typing for HLA-B27 has been usually accomplished by the microcytotoxicity assay in Korea because it does not require special equipment and is easily reproducible. Recently, an immunofluorescence method and the polymerase chain reaction have also been applied for HLA-B27 testing. However, the current economic crisis in Korea have led domestic manufacturers to develop a Korean HLA-B27 typing kit. The aim of this study was to assess the advantages and disadvantages of this kit and to assess the possibility of replacing the currently used foreign-made kits with this domestic one. METHODS: HLA-B27 testing by the microcytotoxicity test was performed on 116 patients during a period of 3 months in 1998. The Biotest typing tray and the Chongkundang typing tray were tested simultaneously. Results: There was no difference in results in 116 samples (positive: 39, negative: 77). The Korean typing tray showed high false positivity of the negative control well (8 point: 1 case, 6 point: 33 cases, 4 point: 47 cases, 2 point: 17 cases, 1 point: 18 cases) and 6 of the HLA-B27 negative cases showed false positivity in one of the four HLA-B27 wells. Typing of HLA-Bw4 and Bw6 revealed an inconsistency in five and six cases, respectively. CONCLUSIONS: Despite of the false positivity of the negative control in Korean panel, we believe that Korean typing tray can replace the foreign-made tray due to its low cost and adequate performance. Because placenta of Korean multiparous women was used for the kit, Chongkundang typing tray seems to correlate better with Korean HLA-B27 subtypes.
Cytotoxicity Tests, Immunologic ; Female ; Fluorescent Antibody Technique ; HLA-B27 Antigen* ; Humans ; Korea ; Placenta ; Polymerase Chain Reaction