Why do Diseases Start One Sided? Clues From HLA-B27 Acute Anterior Uveitis
Bibliographic record
Abstract
Uveitis is an inflammatory disease with significant disease burden, as it causes ≤10% of legal blindness in the USA. Patients are usually affected in their prime working years. Even in those with good treatment response, quality of life is substantially compromised. The most common form of uveitis is acute anterior uveitis, and approximately half of these cases are associated with human leukocyte antigen B27 (HLA-B27). The typical clinical presentation is sudden onset of a red sore eye with white cells and protein leaking into the anterior chamber. There is inter-individual variance in clinical signs, with the most severe cell response appearing like a snowstorm in the anterior chamber, causing cells to pile up in a snowbank appearance called a hypopyon. One of the truly curious, yet pathognomonic, features is the tendency for the inflammatory response to have a unilateral presentation. Either the right or left eye can manifest obvious inflammation, yet the other eye is completely unaffected. Also, subsequent attacks may occur on the same or contralateral side. Clearly, the immune system is capable of distinguishing a molecular variance between the two eyes, but what this difference is remains a mystery. This article will review HLA-B27 uveitis plus its associated systemic diseases; additionally, various mechanisms that play a role in determining left–right disease asymmetry will be discussed. Establishing how the immune system makes this left–right decision will have relevance to understanding causes of asymmetry in other inflammatory, degenerative, and malignant disorders.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.004 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 0.006 |
| Insufficient payload (model declined to judge) | 0.004 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".