HLA-B27 is significantly associated with ankylosing spondylitis in Bangladeshi axSpA patients, and combined evaluation of clinical features and inflammatory markers may aid in early identification and management, particularly in resource-limited settings.
To assess the clinical characteristics, disease activity, functional status, and quality of life of Egyptian patients with axial spondyloarthritis (axSpA), and to evaluate differences according to sex and HLA-B27 status. This cross-sectional study included 256 patients fulfilling the Assessment of SpondyloArthritis international Society (ASAS) classification criteria for axSpA. Clinical, laboratory, imaging, and treatment data were collected. Disease activity was assessed using ASDAS-CRP and BASDAI, functional status using BASFI, spinal mobility using BASMI, and quality of life using ASQoL. Comparisons were performed according to sex, HLA-B27 status, and combined sex/HLA-B27 subgroups. Of 256 patients, 57.4% were male, 55.9% were HLA-B27 positive, and 70.3% had radiographic axSpA. Female patients demonstrated higher disease activity, greater functional impairment, and poorer quality of life, as reflected by higher BASDAI, BASFI, and ASQoL scores. HLA-B27-positive patients more commonly exhibited axial-dominant disease, whereas HLA-B27-negative patients showed higher frequencies of peripheral involvement, enthesitis, and dactylitis. Combined stratification by sex and HLA-B27 status demonstrated that female HLA-B27-negative patients had the highest disease activity, functional impairment, and quality-of-life impairment among all subgroups. Disease expression and patient-reported outcomes in axSpA differ according to both sex and HLA-B27 status. Despite geographic and healthcare-system differences, the observed patterns were broadly consistent with those reported in international cohorts. The combined evaluation of sex and HLA-B27 status may provide additional insight into disease heterogeneity and patient burden in axSpA.
E. Soliman, Magdy Zeheiry, Yasmine Abu Halawa et al.· BMC Musculoskeletal Disorder...· 0 citations
Background/Aims: To compare the clinical characteristics of enthesitis/ spondylitis-related juvenile idiopathic arthritis (E/SpRJIA), a relatively prevalent JIA subtype in Türkiye and India, and to explore potential populationspecific differences in disease expression.
Materials and Methods: This multicenter, binational, retrospective cohort study included children fulfilling the provisional PRINTO classification criteria for E/SpRJIA from 12 pediatric rheumatology centers in Türkiye and India. Demographic characteristics, clinical manifestations, human leukocyte antigen B27 (HLA-B27) status, laboratory findings, disease course, and treatment-related data were collected. A multivariable logistic regression analysis was performed to identify factors independently associated with sacroiliitis at diagnosis.
Results: A total of 498 patients were included (391 Turkish and 107 Indian). At disease onset, peripheral polyarticular involvement was more common in Indian patients (40.2% vs 5.6%), whereas axial involvement was more frequent in Turkish patients (45.8% vs 18.7%). HLA-B27 positivity was higher in Indian patients than in Turkish patients (79.5% vs 56.4%). During follow-up, sacroiliitis, enthesitis, and tarsitis were more common among Turkish patients, while peripheral arthritis and dactylitis were more frequent among Indian patients. NSAIDs were used more frequently in India, whereas conventional and biologic DMARDs were more commonly used in Türkiye. In multivariable analysis, country of origin remained independently associated with sacroiliitis at diagnosis, whereas HLA-B27 positivity did not.
Conclusion: E/SpRJIA demonstrates substantial phenotypic heterogeneity between Turkish and Indian populations. Turkish patients exhibited a predominantly axial disease pattern, whereas Indian patients more commonly showed peripheral polyarticular involvement despite higher HLA-B27 positivity. These findings suggest that factors beyond HLA-B27, including broader genetic, environmental, and population-specific influences, may contribute to differences in disease expression. Further prospective and genetically informed studies are needed to clarify the determinants of this heterogeneity.
Cite this article as: İşgüder R, Sharma A, Kızıldağ Z, et al. Comparison of the Clinical Expression of Patients with Enthesitis/Spondylitis-Related Juvenile Idiopathic Arthritis (E/SpRJIA) from Türkiye and India. ArchRheumatol. Published online September 1, 2026. doi: 10.5152/ArchRheumatol.2026.25122.
Rana Işgüder, Avinash Sharma, Zehra Kızıldağ et al.· Archives of Rheumatology· 0 citations
Background: Reactive arthritis (ReA) is an inflammatory rheumatic disease that belongs to the group of spondyloarthritis (SpA). Etiopathogenesis of ReA, as well as the majority of other SpA entities, is linked with the presence of HLA-B27. However, considerable uncertainty remains regarding the HLA-B27 positivity and its association with the source of infection, clinical, laboratory, and imaging features in ReA. Aim: To assess the prevalence of the HLA-B27 antigen and its relationship with gender and age at onset, source of infection, features of peripheral arthritis, presence of sacroiliitis, and inflammatory burden of ReA. Methods: Patients diagnosed with ReA, who were hospitalized for a work-up and treatment, were evaluated for HLA-B27 status. Demographic data (gender and age at onset), ESR and CRP, number and distribution of clinically affected joints, and presence of sacroiliitis imaging on MRI were obtained and analyzed towards HLA-B27 positivity. Statistical significance was set at P<0.05. Results: A total of 224 patients with a mean age of 32.2±6.9 years were included. The majority were males (135 patients, 60.3%) (P = 0.0021), and the disease mostly started in the age group of 30–39 years (P<0.00001). The overall prevalence of HLA-B27 was 70.5%, with no significant association with any gender (P=0.153). C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels were significantly higher in HLA-B27 positive patients (for both P =0.001). There was a tendency to observe sacroiliitis more frequently in HLA-B27 positive patients, although the result did not reach significance (P = 0.0517). Compared to other locations urogenital tract infection was associated with the highest prevalence of HLA-B27 positivity (P<0.00001). Conclusion: In our study of ReA patients, results indicate that profiling based on HLA-B27 status can be associated with a urogenital source of infection and is valuable for predicting a higher level of systemic inflammation, as well as a tendency to detect sacroiliitis.
A divergent regulation of CD29 and CD49b integrins associated with HLA-B27 status in Iraqi AS patients is suggested and longitudinal validation is required to confirm their clinical utility as diagnostic or therapeutic targets.
Ahmed Ali Alshammari, M. Mohsin· Iranian Journal of Pathology· 0 citations
Inflammatory bowel disease (IBD) and ankylosing spondylitis (AS) are common autoimmune disorders that have a serious impact on the physical and mental health of patients. Some patients with AS also suffer from IBD, and some studies have shown that there is a link between the 2. However, the causal relationship between the 2 is not clear. This study aimed to infer a causal relationship between IBD and AS using Mendelian randomization (MR) analysis. We obtained genome-wide association study data related to IBD and AS from the Integrative Epidemiology Unit database and the Finnish database to infer the causal relationship between IBD and AS. MR analyses were performed using 3 methods, mainly inverse-variance weighting (IVW). The robustness of causal effects was ensured by multiple methods (instrumental variables were assessed using F-values, heterogeneity was detected by Cochran’s Q, horizontal pleiotropy was assessed by MR-Egger regression, and outliers were detected by Mendelian Randomization Pleiotropy RESidual Sum and Outlier and leave-one-out methods). Subsequently, we selected genome-wide association studies data from 3 different databases for an independent two-sample MR analysis and a meta-analysis based on 3 independent MR estimates to assess the causal relationship between IBD and AS. There was a positive causal relationship between Crohn disease (CD) and AS with IVW results (odds ratio = 1.19, 95% confidence interval = 1.12–1.27; P <.01). There was a positive causal relationship between ulcerative colitis (UC) and AS with IVW results (odds ratio = 1.60, 95% confidence interval = 1.28–2.00; P <.01). Neither CD nor UC had an inverse causal relationship with AS. In order to verify the accuracy of the results, we performed a meta-analysis of the results obtained from the 3 MR analyses, and the results were consistent with the results we had previously obtained. CD and UC may increase the risk of AS.
Men with spondyloarthritis (SpA) are characterized by a high incidence of hypogonadism (low testosterone levels). Hypogonadism is associated with higher indicators of systemic inflammation and metabolic disorders.
The aim
– to compare the dynamics of spondyloarthritis activity with changes in total testosterone (TT) levels in men with ankylosing spondylitis (AS) and psoriatic arthritis (PsA).
Materials and methods
. Thirty-six men with AS and 47 men with PsA were included. All patients had their TT levels measured at baseline and during follow-up (on average, after 14.5 [12.8; 17.3] months for AS and 14.0 [9.5; 19.0] months for PsA). Subgroups were identified based on the presence/absence of decreased BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) and DAPSA (Disease Activity in Psoriatic Arthritis) indices, as well as C-reactive protein (CRP) levels. A comparative assessment of quantitative and qualitative indicators reflecting the clinical features of AS and PsA was conducted at baseline and over time, as well as a correlation analysis between the studied quantitative indicators over time.
Results.
An inverse correlation was found between changes in testosterone levels and CRP (ρ=–0.4; p=0.015) in patients with AS. In PsA, no significant correlations were found between changes in TT levels and changes in indicators reflecting activity. In patients with AS, with decreased BASDAI activity, no significant changes in TT levels were observed. At the same time, a decrease in CRP from 9.6 [2.7; 33.9] to 1.9 [0.65; 8.5] mg/L (p<0.001) was accompanied by an increase in TT levels (from 17.9 [12.2; 21.1] to 19.2 [14.2; 23.7] nmol/L; p=0.03), while no such dynamics were observed in the absence of a decrease in CRP. Among patients with PsA, neither a decrease in DAPSA activity nor a decrease in CRP were accompanied by significant dynamics in testosterone levels. In both AS and PsA, the proportion of patients with hypogonadism (TT level ≤12.0 nmol/L) at baseline and over time remained comparable across all comparisons.
Conclusion.
In patients with AS, a decrease in CRP during treatment is accompanied by an increase in TT levels.
T. S. Panevin, T. Korotaeva, T. Dubinina et al.· Rheumatology Science and Pra...· 0 citations
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