{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:04:24Z","timestamp":1787166264927,"version":"build-2736575974"},"reference-count":57,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T00:00:00Z","timestamp":1754438400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d Ia\u0219i, Romania","award":["1929\/25.10.2019"],"award-info":[{"award-number":["1929\/25.10.2019"]}]},{"name":"University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d Ia\u0219i, Romania","award":["127606"],"award-info":[{"award-number":["127606"]}]},{"name":"Romanian Operational Program for Competitiveness 2014\u20132020, Axis 1, under POC\/448\/1\/1 Research Infrastructure Projects for Public R&amp;D Institutions\/Universities \u201cMultidisciplinary Medical Research-Development Platform in the NE region (CENEMED),\u201d","award":["1929\/25.10.2019"],"award-info":[{"award-number":["1929\/25.10.2019"]}]},{"name":"Romanian Operational Program for Competitiveness 2014\u20132020, Axis 1, under POC\/448\/1\/1 Research Infrastructure Projects for Public R&amp;D Institutions\/Universities \u201cMultidisciplinary Medical Research-Development Platform in the NE region (CENEMED),\u201d","award":["127606"],"award-info":[{"award-number":["127606"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>This study examined the distribution and disease associations of non-HLA-B*27 HLA-B alleles in Romanian spondyloarthritis (SpA) patients, aiming to address the underrepresentation of Eastern European populations in immunogenetic research. Methods: We analyzed 263 HLA-B*27-negative patients from Northeastern Romania fulfilling ASAS criteria. HLA-B genotyping was performed at two-digit resolution, and allele distributions were compared with two Romanian HLA-B*27-negative control groups (n = 335 and n = 1705 cases), using chi-square testing and logistic regression. Compared to controls, HLA-B*47 (p = 0.0007) and HLA-B*54 (p = 0.0013) were significantly enriched, while HLA-B*40 was underrepresented (p = 0.0287). Notably, HLA-B*54 was observed exclusively in axial SpA. Within the cohort, both HLA-B*13 and HLA-B*57 alleles were associated with psoriasis, while HLA-B*37 and HLA-B*41 alleles were clustered within the reactive arthritis group. The HLA-B*35 and HLA-B*18 alleles were the most frequently observed alleles across most clinical phenotypes. When comparing the frequency of HLA-B associations, the most common genotypes among SpA patients were B*08-B*18, B*13-B*35, and B*35-B*51. Notably, B*08-B*18 was more frequent in patients with radiographic sacroiliitis grade \u2265 2, while B*35-B*51 was more frequent in those with confirmed systemic inflammation, as indicated by elevated CRP or ESR levels. Analysis of peptide-binding patterns revealed a cluster of risk alleles, HLA-B*08, B*18, B*35, B*40, and B*54, sharing similar features, distinct from the canonical profile of B*27. These findings highlight the contribution of non-B*27 HLA-B alleles to SpA susceptibility in an Eastern European population and support the notion that HLA-B*27-negative SpA may represent a distinct clinical and immunological entity, driven by alternative pathogenic mechanisms. They also emphasize the importance of population-specific immunogenetic profiling and support expanding genetic characterization in HLA-B*27-negative patients.<\/jats:p>","DOI":"10.3390\/ijms26157617","type":"journal-article","created":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T15:09:53Z","timestamp":1754492993000},"page":"7617","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Genetic Complexity in Spondyloarthritis: Contributions of HLA-B Alleles Beyond HLA-B*27 in Romanian Patients"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9750-1203","authenticated-orcid":false,"given":"Ruxandra-Elena","family":"Nagit","sequence":"first","affiliation":[{"name":"Immunology Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2802-5993","authenticated-orcid":false,"given":"Mariana","family":"Pavel-Tanasa","sequence":"additional","affiliation":[{"name":"Immunology Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"},{"name":"Immunology Laboratory, \u201cSt. Spiridon\u201d Clinical Hospital, 700106 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corina","family":"Cianga","sequence":"additional","affiliation":[{"name":"Immunology Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"},{"name":"Immunology Laboratory, \u201cSt. Spiridon\u201d Clinical Hospital, 700106 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8175-2583","authenticated-orcid":false,"given":"Elena","family":"Rezus","sequence":"additional","affiliation":[{"name":"Rheumatology Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"},{"name":"Rheumatology Clinic, Clinical Rehabilitation Hospital, 14 Pantelimon Halipa Street, 700661 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5403-2265","authenticated-orcid":false,"given":"Petru","family":"Cianga","sequence":"additional","affiliation":[{"name":"Immunology Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"},{"name":"Immunology Laboratory, \u201cSt. Spiridon\u201d Clinical Hospital, 700106 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1177\/1759720X18773726","article-title":"Ankylosing Spondylitis and Axial Spondyloarthritis: Recent Insights and Impact of New Classification Criteria","volume":"10","author":"Proft","year":"2018","journal-title":"Ther. Adv. Musculoskel. Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1136\/ard.2009.108233","article-title":"The Development of Assessment of SpondyloArthritis International Society Classification Criteria for Axial Spondyloarthritis (Part II): Validation and Final Selection","volume":"68","author":"Rudwaleit","year":"2009","journal-title":"Ann. Rheum. 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