What is the basis for the association of acute anterior uveitis (AAU) with human leukocyte antigen (HLA) B27?

Updated: Oct 30, 2018
  • Author: Anna Luisa Di Lorenzo, MBBCh; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Answer

Answer

Several hypotheses with animal models have been proposed to explain the association of AAU and HLA-B27. Many cases of uveitis or reactive arthritis follow gram-negative bacillary dysentery or chlamydial infection. These gram-negative organisms include Shigella, Salmonella, Klebsiella, and Yersinia species. Similarities in the gram-negative cell wall lipopolysaccharide present in these microbes may explain their immunogenicity. Animal experiments with rodents that have been genetically altered to express human HLA-B27 molecules show that bacterial infection of the gut predisposes to arthritis and a reactive arthritis–like syndrome. Also, chronic intracellular chlamydial joint or eye infection might stimulate, via the HLA-B27 molecule, a CD8 T-cell effector mechanism activated to kill the infections, which coincidentally also indirectly injures the eye. [8]


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