Study On HLA-B27 Typing,antigen Purification,and Expression In Ankylosing Spondylitis And Clinical Analysis Of 167 Patients

Alum: 1.To analyze clinical roatures of unkyloslng spondylltls (AS) and to discuss curly diagnosis of AS, so as to elevate diagnostic level of AS. 2. To oval uate three different methods for measurement of IILA-B27. 3. To study possible relationship between expression of IILh-B27 at both RNA and protein level and pathogenesls and clinical features of AS. 4. To isolate and purify HLA-B27 antigen of AS in order to prepare technique and method for study on relationship between peptldes presented by IILA-B27 and pathogenesis of AS. Uaterialm and Methods: LClinical materials and laboratory examinations of 130 AS patients diagnosed by author in two-your clinical work were reviewed. Patients at early, middle, and late stage of AS, Juvenile AS and adult AS, ale AS and female AS, B27-posltlve AS and B27-negative AS were compared respectively. 2. Diagnosis criteria for JAS proposed by Sill Gulylng, ESSG and Amer diagnosis and classification criteria for spondyloarthropathy were used to re-evaluate 37 patients with suspicious AS. 3. HLA-B27 was determined by PCR-SSP and mlcrolymphocytoxiclty test using anti-B27 monoclonal antibody (lAb) In 138 patIentswith definite and suspicious AS. 4. Expression or HLA-B27 antigen on leukocyte and T lymphocyte subgroup was measured by flow cytometry using NAb. Data of 027-positive and 1327-negative patients were compared. The difference among 1327-positive patients of AS subgroups and the relationship between B27 expression and pathogenesis and clinical features of AS were studied. 5. Expression of HLA-B27 mRNA of leukocyte of 027-positive AS patients was measured by RT-PCR using ctln for inside control. The di rferenc among AS subgroups and the relationship between 1327 mRNA expression and 827 protein expression, pathogonesis and ci inical roatiir ti or As were stud i od. 6. Specific affinity column coupled to NAb was used to isolate and purify IILA-B27 antigen on surface of peripheral blood mononuclear cell from AS patients. The purity and molecular mass of purified protein was determined by 51)5-PAGE. Result.: 1. 130 patients with definite AS and 37 patients with suspicious AS were about 5% of out-patients. 70% of AS patientswere at middle and late stage. Of the 130 patients, with ale to female ratio was 5.2:1, there were 37 cases of JAS and 93 cases of MS. Sex ratio of JAS (11:1) was greater than that of MS (4.2:1), and JAS patients with peripheral symptom at onset and wi th peripheral part Involved wore predominantly more popular than MS patients. Moreover, more JAS possessed IILA-B27 than MS. Among male AS, the population at late stage was the greatest (approximately 50%). But in female AS, the greatest population was at early stage (more than 50%). The average age at disease onset of female AS yas older than that of male AS, significantly (P(O.O1). [urthermore, the prevalence of peripheral symptom at onset, peripheral part involvement, lumbar spine, chest, cervical spine, and hip joint ankylosis in male AS was higher than that in female AS. More male AS had IILA-B27 than female AS. 1327-positive AS patients had a higher risk of developing ankylosing spine or hip joint than B27-negative patients. About a half of B27-positive AS was at late stage, but none of 1327-negative AS was at late stage. Average ESR...