From L.M. Mcewen
You recently carried an account of research into the link between the HLA-B27 gene, spondyloarthropathy and gut bacteria (This Week, 17 December). The report suggests that the link remains a puzzle and that the development of a mouse strain carrying the HLA-B27 gene will permit further research to understand the link.
This is very puzzling. Alan Ebringer of King’s College London first described cross-reactivity between Klebsiella aerogenes and B27 lymphocyte antigens in ankylosing spondylitis as long ago as 1976 (in Dausset J, Svejgaard A, Eds. HLA and disease. Paris: INSERM, 1976).
Ebringer has continued this work, showing quite clearly that epitopes associated with HLA-B27 in the paraspinal tissue resemble epitopes on Klebsiella. Patients with ankylosing spondylitis have cross-reacting IgA in their blood. This work has been confirmed by several groups of workers.
