Ankylosing Spondylitis — HLA-B27 present in 90-95% of patients but still taking an average of 7-10 years to diagnose, during which irreversible sacroiliac and spinal joint damage accumulates without anti-inflammatory treatment.
Whole genome sequencing provides complete HLA-B allele typing — identifying the specific HLA-B27 subtype with differential disease risk — supporting earlier diagnosis of inflammatory back pain and enabling prompt access to biologic therapy that prevents structural damage.
Ankylosing Spondylitis — HLA-B27
Ankylosing spondylitis (AS), also called radiographic axial spondyloarthritis (r-axSpA), is a chronic immune-mediated inflammatory arthritis predominantly affecting the sacroiliac joints and spine. AS affects approximately 0.1-0.5% of European populations and is strongly associated with HLA-B27 — present in 90-95% of AS patients in European populations, compared to approximately 8% of the general European population. Despite this strong genetic signal, the average time from symptom onset to AS diagnosis is 7-10 years, during which active spinal inflammation causes progressive structural damage — sacroiliac erosion, syndesmophyte formation, and eventual vertebral fusion ('bamboo spine') — that is preventable with early biologic therapy.
HLA-B27 is not a single allele but a family of closely related variants. Over 170 HLA-B27 subtypes have been described (B*27:02 through B*27:173). The common disease-associated subtypes in European populations (B*27:05, B*27:02) carry the highest AS risk. B*27:06 (common in Southeast Asia) and B*27:09 (in Sardinia) are associated with dramatically lower AS risk despite sharing most of the B27 protein structure — a finding that has informed understanding of the pathogenic mechanism. B*27:01 is rare and also associated with low disease risk. Complete HLA-B27 subtype determination, rather than a simple B27 positive/negative result, provides clinically meaningful information about the level of AS risk in a B27-positive individual, particularly relevant for non-European ancestry populations.
The clinical utility of HLA-B27 typing in AS lies primarily in accelerating diagnosis. In a young adult presenting with inflammatory back pain (onset <45 years, insidious onset, morning stiffness >30 minutes, improvement with exercise, no improvement with rest), HLA-B27 positivity combined with suggestive imaging makes an AS diagnosis highly likely — ASAS classification criteria for axial spondyloarthritis include HLA-B27 as a major criterion. The biological rationale for damage prevention with early TNF inhibitor or IL-17 inhibitor treatment is well-established: these therapies suppress spinal inflammation but do not reverse established structural lesions. HLA-B27 testing in the early phase of inflammatory back pain is cost-effective if it accelerates time to diagnosis and biologic therapy by even 1-2 years.
HLA-B*27:06 (Southeast Asian populations) and B*27:09 (Sardinia) carry dramatically lower AS risk despite a B27-positive test result. Subtype identification from whole genome sequencing distinguishes truly high-risk B27 from low-risk subtypes.
Standard HLA-B27 commercial tests report positive/negative without subtype. Complete HLA-B typing from whole genome sequencing identifies the specific B27 subtype — differentiating high-risk from low-risk subtypes that are clinically indistinguishable by standard testing.
HLA-B*27:06 tests B27-positive but confers much lower AS risk than B*27:05 — subtype matters
Standard HLA-B27 commercial assays report a dichotomous B27-positive or B27-negative result. B*27:06, common in Thai and other Southeast Asian populations, tests positive on standard HLA-B27 assays — but carries dramatically lower AS risk. A Southeast Asian patient who tests B27-positive and is counseled that they have 'a high-risk allele for ankylosing spondylitis' may receive inaccurate risk information if they carry B*27:06 rather than B*27:05 or B*27:02. Complete HLA-B allele typing at 4-digit field resolution from whole genome sequencing identifies the precise B27 subtype, enabling accurate risk stratification and appropriate counseling.
The same test that evaluates HLA-B27 also covers all other pharmacogenomically actionable HLA alleles
AS patients receiving biologic therapy — TNF inhibitors (adalimumab, etanercept) or IL-17 inhibitors (secukinumab, ixekizumab) — are often also managed for comorbidities requiring medications with HLA pharmacogenomic considerations. The same HLA-B*27 status from whole genome sequencing is generated alongside HLA-B*57:01 (abacavir risk), HLA-B*15:02 (carbamazepine risk in Asian patients), and HLA-B*58:01 (allopurinol risk). AS patients prescribed allopurinol for concurrent gout — common given shared metabolic risk factors — benefit from knowing their HLA-B*58:01 status. Whole genome sequencing delivers all of these results from a single DNA sample.
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Traditional genetic testing looks at narrow sets of genes, missing most parts of your genome. We sequence your full genome — every gene and every region between genes.
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A patient had spent decades in the UK healthcare system without a diagnosis. Dante data, accepted by NHS clinical teams at Queen Elizabeth University Hospital Glasgow, identified Noonan Syndrome and a RUNX1 leukemia-associated variant that had gone undetected. After 40 years, they finally had an answer.
A complete read delivers a complete picture.
A patient came to Dante to investigate periodic paralysis. Reading the complete genome identified a concurrent hereditary cardiac finding — Brugada syndrome — that their doctor confirmed with an ECG. The result also explained a family member's unresolved cardiac history. One test. Every answer in it.
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Jennifer sequenced her genome with Dante two years before her breast cancer diagnosis. When treatment began, Dante's pharmacogenomics data showed her prescribed chemotherapy would cause serious adverse effects. Her doctor selected an alternative — and she started effective treatment from day one.
Every genetic question deserves a complete answer.
Whether you are searching for answers today or protecting your health for tomorrow, a complete read of your entire genome is the only place to start.
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Your genome contains inherited variants associated with medical conditions like cardiac, cancer, and neurological. We read all of them — with the clinical depth to give the result meaning.
Learn more →When traditional lab tests say you're fine. And you know you're not.
Standard diagnostic tests check for a pre-selected set of answers. We sequence your full DNA — including parts that no test was designed to check. If the answer is in your genome, we will help you find it.
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Your genes determine which treatments are most likely to work — and which are not. We give your doctor the tools and insights to inform your treatment plan.
Learn more →You want to know before something forces the question.
Some people don't wait for a diagnosis or a family history to act. Whole genome sequencing gives you the complete genetic picture now — so you and your doctor can make informed decisions before anything becomes urgent.
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Dante Genome Test helped specialists at a UK national acute hospital in the identification of Noonan Syndrome and a rare leukemia-associated genetic variant that had gone undetected. That result changed the medical care of the patient.
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Common questions about whole genome sequencing.
What is the difference between whole genome sequencing and a targeted genetic test?
Targeted genetic tests — including standard hereditary cancer panels — read a pre-defined list of known variants in a specific set of genes. They are designed to find what they already know to look for. Whole genome sequencing reads your entire genome: all 6 billion base pairs, every gene, every region between genes. A Mayo Clinic study published in JAMA Oncology found that standard testing guidelines missed more than half of patients with inherited cancer mutations. Genome Test does not have a fixed list.
What will I receive when my results are ready?
Your Dante Genome delivers 200+ physician-ready reports organized by clinical category — hereditary cancer, cardiac conditions, rare diseases, pharmacogenomics, carrier status, and more. Reports are delivered to your secure Genome Manager and are formatted for direct clinical use. Your genome data is permanently retained and re-analyzed automatically as science advances.
What happens if a clinically significant variant is found?
If a pathogenic or likely-pathogenic variant is identified, it will be clearly flagged in your physician-ready report with clinical context, published evidence, and recommended next steps. We recommend sharing any clinically significant finding with your physician or a genetic counselor, who can guide decisions about surveillance, risk reduction, or cascade testing for family members.
How is this different from a consumer DNA test like 23andMe or AncestryDNA?
Consumer DNA tests use genotyping chips that read less than 0.1% of your genome — a tiny pre-selected set of common variants. They are optimized for ancestry and population-level traits, not clinical genetic findings. The Dante Genome Test sequences 100% of your genome at 30X coverage, the same standard used in clinical diagnostic settings. The two tests are not comparable in scope, methodology, or clinical utility.
How long does it take to get results, and how are they delivered?
Your collection kit ships within 48 hours of ordering. Once your sample arrives at our CLIA-certified laboratory, sequencing and analysis takes 6–8 weeks. Results are delivered securely to your Genome Manager, where you can access your reports, share them with your physician, and receive automatic updates as new findings are validated against your genome.
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Dante Labs works with patient advocacy groups of any size — for Ankylosing Spondylitis — HLA-B27 and other conditions, rare and common. We support groups in any country, including virtual patient advocacy groups.
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Ships within 48 hours · Results in 6–8 weeks
