HLA B27 histocompatibility antigen is correlated With
**Core Concept**
HLA B27 is a human leukocyte antigen (HLA) that plays a crucial role in the immune system by presenting peptides to T-cells, thereby influencing the body's response to various infections and autoimmune diseases. The association between HLA B27 and certain conditions is thought to be due to the increased expression of HLA B27 in the joints and spinal cord, leading to immune-mediated inflammation.
**Why the Correct Answer is Right**
Ankylosing spondylitis (AS) is a chronic inflammatory disease primarily affecting the spine and sacroiliac joints, leading to severe back pain and stiffness. The presence of HLA B27 has been strongly linked to the development of AS, with approximately 90% of patients testing positive for the antigen. This association is believed to be due to the increased expression of HLA B27 in the joints, leading to the activation of T-cells and the production of pro-inflammatory cytokines, which contribute to the inflammation and tissue damage characteristic of AS. The HLA B27 molecule also has a higher affinity for binding and presenting peptides to T-cells, which may contribute to the disease's pathogenesis.
**Why Each Wrong Option is Incorrect**
**Option A:** Sjogren's disease is an autoimmune disorder characterized by exocrine gland dysfunction, particularly affecting the salivary and lacrimal glands. While Sjogren's disease has been linked to various HLA alleles, there is no strong association with HLA B27.
**Option C:** Felty's syndrome is a complication of long-standing rheumatoid arthritis, characterized by the presence of rheumatoid factor, neutropenia, and splenomegaly. HLA B27 is not typically associated with Felty's syndrome.
**Option D:** Scleroderma is a chronic autoimmune disease characterized by skin and organ fibrosis. While HLA alleles have been linked to scleroderma, there is no strong association with HLA B27.
**Clinical Pearl / High-Yield Fact**
It is essential to remember that the presence of HLA B27 is not diagnostic of ankylosing spondylitis, as many healthy individuals also test positive for the antigen. However, a positive HLA B27 test can increase the likelihood of developing AS, especially in individuals with a family history of the disease.
**✓ Correct Answer: B. Ankylosing spondylitis**