The HLA-B27 gene has a strong connection with autoimmune disorders. Still, you can carry this variant and maintain flawless health. Knowing your genes and applying personalized health tips makes all the difference – read on and learn how to hack your “autoimmunity gene.”
We have a more personalized version of this blog post. Check out our post on the SelfDecode blog.
What is HLA-B27?
The HLA System
The human leukocyte antigen (HLA) system is a group of human genes encoding the major histocompatibility complex (MHC) proteins, or HLAs. This system has three groups or classes; HLA-B genes, along with HLA-A and HLA-C, belong to the class I .
HLAs are proteins or antigens on the surface of white blood cells. They help flag and remove external components that may cause infection. HLA-B antigens bring bacterial or viral proteins from the inside to the cell surface so T-lymphocytes can detect and kill the infected cell .
HLA genes come in many different forms or variants, which enable fine-tuning of your immune system. Their diversity can be a double-edged sword, however, as some types increase the risk of autoimmune disorders .
The HLA genes encode proteins (antigens) that bring external components to the surface of white blood cells, enabling your immune system to detect and destroy them.
The HLA-B27 antigen supports antiviral immune response by “flagging” peptides from viruses – such as influenza, HIV, and Epstein-Barr – and presenting them to T-killer cells .
The most common variations associated with autoimmunity are :
- HLA-B*27:05 (Caucasians/whites)
- HLA-B*27:04 (Chinese)
- HLA-B*27:02 (Mediterranean)
On the other hand, HLA-B*27:06 seems to reduce the risk .
HLA-B27 enables an antiviral immune response, but certain subtypes also raise the risk of autoimmune disorders.
The prevalence of HLA-B27 varies from 50% in some Indian populations to almost zero in Australian Aborigines. About 6% of the US population carries this variant, which is more common among white people .
HLA-B27 and Autoimmune Diseases
Ankylosing Spondylitis (AS)
As mentioned, HLA-B27 greatly increases the risk of certain autoimmune diseases, such as :
- Ankylosing spondylitis (spine deformation)
- IBD (inflammatory bowel disease), in combination with spondylitis
- Reactive arthritis (Reiter’s syndrome) – inflammation of joints, urethra, and eyes
These conditions have a common name spondyloarthritis, the main one being ankylosing spondylitis (AS). In AS, inflammation gradually fuses spine vertebrae, causing back pain and limited movement. It usually affects young men [12, 13].
HLA-B27 raises the risk of autoimmune disorders known under the name spondyloarthritis. The main one is ankylosing spondylitis, which causes spine inflammation and chronic back pain.
What Is The Risk?
The connection between HLA-B27 and ankylosing spondylitis (AS) is among the strongest in the HLA system: 90–95% of all AS patients have this variant. For other conditions, the prevalence ranges between 50-90% .
Does this mean almost everyone with HLA-B27 will get AS or another autoimmune disease? Not at all!
Over 50% of people with anterior uveitis (eye inflammation) have this variant, but only 1% of all HLA-B27 carriers develop uveitis .
In other words, HLA-B27 raises the risk of the above disorders, but many more factors contribute and decide which carriers will get them. That’s where our personalized lifestyle and dietary recommendations kick in – stay tuned for the details!
Between 50 and 95% of spondyloarthritis patients have the HLA-B27 variant, but many other factors are involved. You can cut the risk with specific dietary and lifestyle changes.
- The way it binds and presents peptides to T-killer cells: upon activation, T-killer cells can mistakenly flag all HLA-B27 fragments as foreign peptides and attack them
- The biochemical properties (structure) of HLA-B27 itself: it can misfold in such a way that causes intracellular inflammation and triggers an immune response
Whatever the root cause, inflammation is the chief mechanism in autoimmune disorders .
Who Should Test?
- Have chronic pain, stiffness, and inflammation in your joints
- Have painful eye inflammation (uveitis)
- The above symptoms began your early adulthood (the 20s or 30s)
Your doctor will order HLA tests if you’re undergoing organ or tissue transplantation .
- rs4349859 ( “A” allele correlates with HLA-B27, “G” doesn’t)
- rs13202464 (“G” allele correlates with HLA-B27, “A” doesn’t)
- rs116488202 (“T” allele correlates with HLA-B27, “C” doesn’t)
Carrying two alleles of HLA-B27 (homozygosity) doesn’t increase your risk of autoimmune diseases, compared with one allele .
Please note: To confirm the presence of this variant and detect the exact subtype, you may want to do the HLA-B27 blood test.
- Erythrocyte sedimentation rate (ESR) – high value indicates inflammation
- C-reactive protein (inflammation)
- Rheumatoid factor
- TNF-alpha (inflammation)
If you’ve started experiencing joint pain and stiffness in early adulthood, you may want to test for the HLA-B27 variant and check lab markers of autoimmunity and inflammation.
As mentioned, HLA-B27 is just a link in the chain of risk factors that contribute to spondyloarthritis; scientists have discovered other genes and triggers.
We have compiled a list of genetic traits associated with ankylosing spondylitis.
Microbiome and Infections
Microbial infections can trigger autoimmune disorders by disturbing the gut probiotics, the guardians of your immunity. Reactive arthritis (previously known as Reiter’s syndrome) is associated with the following infections [44, 45, 46]:
Other factors that may contribute to autoimmune diseases include:
- C-section delivery 
- Antibiotics [50, 51]
- Environmental toxins 
- Sleep deprivation [53, 54]
- Stress 
Besides HLA-B27, factors that contribute to autoimmunity include other genes, microbiome impairment, toxins, sleep deprivation, stress, and persistent infections.
Do you belong to a fraction of people with the HLA-B27 variant? Instead of desperately concluding that autoimmunity “runs in your family,” you can hack your genes with personalized dietary and lifestyle changes.
You might be fueling inflammation and autoimmune disorders with your diet! The Lectin Avoidance Diet has a powerful program to help you detect and eliminate foods that are pro-inflammatory for you (hint: it’s not just about lectins).
Given the role of the microbiome and bacterial infections in autoimmunity triggered by HLA-B27, make sure to boost your gut health by:
- Consuming fermented and other probiotic-rich foods
- Feeding the good bacteria with prebiotics
- Including natural antibiotics in your diet
Try The Lectin Avoidance Diet; cut back on sugar and starch; eat foods rich in probiotics, prebiotics, zinc, and copper; practice intermittent or other types of fasting.
To keep inflammation in check and prevent autoimmune disorders, try to:
- Get enough sunlight [64, 65]
- Practice yoga 
- Exercise in moderation [67, 68]
- Get enough sleep [69, 70, 71]
- Try cryotherapy [72, 73, 74]
The following supplements may help with ankylosing spondylitis and autoimmunity in general by supporting your immune system and reducing inflammation:
- Vitamin D (not a substitute for sunlight) [75, 76]
- Probiotics (Lactobacillus GG) [77, 78]
- Turmeric [79, 80, 79]
- CBD oil [81, 82]
- Omega-3/fish oil 
- Green tea (EGCG) [84, 85]
- Quercetin [86, 87, 88]
- Thunder god vine [89, 90]
To get personalized and step-by-step guidance, check out SelfDecode Wellness Reports; they cover inflammation, sleep, fitness, and other essential topics for health optimization.
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