What is the role of HLA-B27 in the pathophysiology of reactive arthritis (ReA)?

Updated: Dec 24, 2020
  • Author: Carlos J Lozada, MD; Chief Editor: Herbert S Diamond, MD  more...
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The role of HLA-B27 in this scenario remains to be fully defined. The following theories have been proposed:

  • Molecular mimicry - This hypothesis suggests that a similarity exists at the molecular level between the HLA-B27 molecule and the inciting organisms, allowing the triggering of an immune response and the subsequent development of clinical disease [26]

  • HLA-B27 as a receptor for certain bacteria - At present, there is little evidence either to confirm or to refute this hypothesis

  • Defective class I antigen-mediated cellular response - This hypothesis suggests that the HLA-B27 molecule may be a defective molecule associated with an aberrant cytotoxic T-cell response

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