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Org recommended by Peabody:
for antibiotic therapy for rheumatoid arthritis, scleroderma, juvenile rheumatoid arthritis, lupus, dermatomyositis, ankylosing spondylitis, Lyme disease, Reiter's syndrome, mixed connective tissue disease, fibromyalgia and psoriatic arthritis.
Peabody says they are relieved of all sx (reactive arthritis, psoriatic, ankylosing spondylitis) by avoiding all grains
HLA-B27 is present in 90% of ankylosing spondylitis pts
more like 25-50% of psoriatic arthritis pts, more in the ones with "pustulent" psoriasis which is also characterized by pitted nails
I forgot what % of Reiters aka reactive arthritis pts are + for HLA-B27 but it's between the two above
HLA-B27 is an MCH type I meaning it is on all cells and is intended to present "self" antigen
Mechanism unknown, several theories
1) HLA-B27 has a protein series that looks a lot like an epitope on certain bacteria so when the body mounts an immune rxn to those bacteria, it reacts to this MCH on all cells. Makes sense with reactive arthritis which happens after urethritis (mostly in men) or GI infx (equally in men and women), but B27 not present in all dxd with r. arth.
2) HLA-B27 accidentally binds a non-self antigen, due to affinity too high.
3) Some other innate etiology unrelated to B27 (but still too much correlation for coincidence so I don't buy this one.
4) something to do with T cell action, not well explained
5) B27 may be located adjacent to the troublemaking gene in the DNA, and hence is associated with disease but not directly causal, because it is produced at the same time.