Immunogenetic profiling of HLA antigens in psoriatic arthritis: insights into clinical variability

Abstract

Introduction. Psoriatic arthritis (PsA) is a complex autoimmune disease with genetic and immunological components influencing its pathogenesis. HLA antigens are critical in determining genetic predisposition and clinical variability. This study aims to explore HLA antigen diversity in PsA patients and its relationship to clinical variants. Material and methods. A cohort of 103 PsA patients, diagnosed according to CASPAR (2006) criteria, was studied. Patients were received treatment in rheumatology departments from 2005–2024. Two groups were formed: 76 patients with PsA and cutaneous psoriasis (Group I) and 27 without cutaneous manifestations (Group II). Each group was further subdivided into clinical variants: axial, oligoarticular, polyarticular, distal interphalangeal, and mutilans. Results. Significant correlations were identified between HLA antigens and PsA severity. Aggressive HLA antigens, including HLA-B27, B8, and B62, were associated with severe disease forms and high DAPSA scores (≥50), while protective antigens like HLA-A2 and A3 correlated with reduced activity (DAPSA <20). Group I exhibited HLA-B27/B62 and HLA-B27/A3 combinations linked to mixed articular and cutaneous involvement, whereas Group II had distinct profiles (e.g., HLA-B27/ B62, HLA-B27/B11). Factorial analysis highlighted the immunogenetic variability between clinical subtypes, emphasizing HLA antigens’ predictive and therapeutic relevance. Conclusions. HLA antigens significantly influence PsA severity and clinical diversity. Integrating genetic profiling into clinical practice offers promising opportunities for improving diagnostic precision, therapeutic outcomes, and patient quality of life.