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Genetic aspects of rheumatoid arthritis

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Summary

Studies on the population of patients with rheumatoid arthritis and families with multiple cases of rheumatoid arthritis have provided definite evidence that susceptibility to the disease is determined both by genetic factors associated with alleles of the major histocompatibility complex as well as environmental factors. The development of seropositive, but not seronegative rheumatoid arthritis is associated with the presence in an individual of the la alloantigen HLA-DR4. This association is common to all major ethnic groups. Some evidence exists that this association is stronger in patients that have more severe disease but this fact requires further study. The fraction of the seropositive patients with rheumatoid arthritis that lack HLA-DR4 has not been well characterized. The occurrence of certain untoward side effects of therapy is influenced by the presence of HLA-DR2 or HLA-DR3.

Family studies emphasize the association with HLA-DR4, and indicate that the disease has a dominant mode of inheritance with partial penetrance. The inheritance of susceptibility appeared, at least in some families, to be primarily associated with the inheritance of HLA-DR4 itself and not well explained by a hypothetical disease susceptibility gene present at low frequency and associated in linkage disequilibrium with a HLA-DR4 marker. However, in others different mechanisms appeared more likely. A model of two MHC genes involved in influencing disease susceptibility is postulated. Speculations concerning the primary disease mechanism are presented involving abnormalities of IR genes, general immune regulation, and factors outside of the immune system.

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References

  1. Astorga GP, Williams RC Jr (1969) Altered reactivity in mixed lymphocyte culture of lymphocytes from patients with rheumatoid arthritis. Arthritis Rheum 12: 547

    PubMed  Google Scholar 

  2. Bennet PH (1975) Some problems in the genetics and epidemiology of rheumatoid arthritis. In: Dumonde DC (ed) Infection and immunology in the rheumatic diseases. Blackwell Scientific Publications.

  3. Burmester GR, Bona AD, Waters SJ, Kunkel HG, Winchester RJ (to be published) Expression of Ia antigens and macrophage differentiation antigens on synovial lining cells of patients with rheumatoid arthritis. Clinical Research

  4. Calin A (1979) HLA-DRw4 rheumatoid factor, and prognosis in rheumatoid arthritis. Lancet i: 873

    Article  Google Scholar 

  5. Dobloug JH, Forre O, Kass E, Thorsby E (1980) HLA antigens and rheumatoid arthritis. Association between HLA-DRw4 positivity and IgM rheumatoid factor production. Arthritis Rheum 23: 309

    PubMed  Google Scholar 

  6. Engleman EG, Sponzilli E, Batey ME, Ramcharan S, McDevitt HO (1978) Mixed lymphocyte reaction in healthy women with rheumatoid factr. Lack of association with HLA-Dw4. Arthritis Rheum 21: 690

    PubMed  Google Scholar 

  7. Gibofsky A, Winchester R, Hansen J, Patarroyo M, Dupont B, Paget S, Lahita R, Halper J, Fotino M, Yunis E, Kunkel HG (1978) Contrasting patterns of newer histocompatibility determinants in patients with rheumatoid arthritis and systemic lupus erythematosus. Arthritis Rheum 21: 134

    Google Scholar 

  8. Gibofsky A, Winchester RJ, Patarroyo M, Fotino M, Kunkel HG (1978) Disease associations of the Ia-like human alloantigens. J Exp Med 148: 1728

    PubMed  Google Scholar 

  9. Harwald B, Hauge M (1965) Hereditary factors elucidated by twin studies. In: Neel JV, Shaw MW, Schull WJ (eds) Genetics and the epidemiology of chronic diseases. PHS Publication No. 1163. US Government Printing Office, Washington D.C., p 61

    Google Scholar 

  10. Husby G, Gran JT, Ostensen M, Johannessen A, Thorsby E (1979) HLA-DRw4 and rheumatoid arthritis. Lancet i: 548

    Google Scholar 

  11. Jaraquemada D, Pachoula-Papasteriadis C, Festenstein H, Sachs JA, Roitt IM, Corbett M, Ansell B (1979) HLA-D and DR determinants in rheumatoid arthritis. Transplant Proc II: 1306

    Google Scholar 

  12. Khan MA, Kushner I, Ballou SP, Braun WF (1979) Familial rheumatoid arthritis and HLA-DRw4. Lancet i: 921

    Article  Google Scholar 

  13. Kueppers F, Brackertz D, Mueller-Eckhardt C (1972) HL-A antigens in sarcoidosis and rheumatoid arthritis. Lancet 2: 1425

    Article  Google Scholar 

  14. Lawrence JS (1967) Genetics of rheumatoid factor and rheumatoid arthritis. Clin Exp Immunol 2: 769

    PubMed  Google Scholar 

  15. Lawrence JS (1970) Heberden oration, 1969-rheumatoid arthritis-nature or nurture? Ann Rheum Dis 29: 357

    PubMed  Google Scholar 

  16. Lawrence JS, Wood PHN (1968) Genetic influences. In: Duthie JJR, Alexander WRM (eds) Rheumatoid arthritis in rheumatic diseases. Pfizer Medical Monographs, No. 3. University Press, Edinburgh, p 19

    Google Scholar 

  17. Lies RB, Messner RP, Troup GM (1972) Histocompatibility antigens in rheumatoid arthritis. Arthritis Rheum 15: 524

    PubMed  Google Scholar 

  18. McMichael AJ, Sasazuki T, McDevitt HO, Payne RO (1977) Increased frequency of HLA-Cw3 and HLA-Dw4 in rheumatoid arthritis. Arthritis Rheum 20: 1037

    PubMed  Google Scholar 

  19. Nunez G, Moore S, Ball GV, Hurd E, Khan MA, Stastny P (1980) The inheritance of HLA haplotypes in families with adult rheumatoid arthritis. Arthritis Rheum 23: 726

    Google Scholar 

  20. Nyulassy S, Ravingerova G, Zvarova E, Bue M (1974) HLA antigens in rheumatoid arthritis. Lancet i: 450

    Article  Google Scholar 

  21. Oliver RTD (1978) HLA-D locus and susceptibility to disease. Nature 274: 14

    PubMed  Google Scholar 

  22. Panayi GS, Wooley P (1977) B lymphocyte alloantigens in the study of the genetic basis of rheumatoid arthritis. Ann Rheum Dis 36: 365

    PubMed  Google Scholar 

  23. Panayi GS, Wooley P, Batchelor JR (1978) Genetic basis of rheumatoid disease: HLA antigens, disease manifestations, and toxic reactions to drugs. Br Med J 2: 1326

    PubMed  Google Scholar 

  24. Roitt IM, Corbett M, Festenstein H, Jaraquemada D, Papasteriadis C, Hay FC, Nineham LJ (1978) HLA-DRW4 and prognosis in rheumatoid arthritis. Lancet 1: 990

    Article  Google Scholar 

  25. Scherak R, Smolen JS, Mayr WR (1980) Rheumatoid arthritis and B lymphocyte alloantigen HLA-DRw4. J Rheumatol 7: 9

    PubMed  Google Scholar 

  26. Seignalet J, Clot J, Sany J (1972) HL-A antigens in rheumatoid arthritis. Vox Sang 23: 468

    PubMed  Google Scholar 

  27. Stastny P (1976) Mixed lymphocyte cultures in rheumatoid arthritis. J Clin Invest 57: 1148

    PubMed  Google Scholar 

  28. Stastny P (1978) Association of the B-cell alloantigen DRw4 with rheumatoid arthritis. N Engl J Med 298: 869

    PubMed  Google Scholar 

  29. Stastny P (1980) Rheumatoid arthritis. In: Terasaki P (ed) VIII International Histocompatibility Workshop Report. p 681

  30. Svejgaard A, Jersild C, Staub Nielsen L, Bodmer WF (1974) HLA antigens and disease statistical and genetical considerations. Tissue Antigens 4: 95–105

    PubMed  Google Scholar 

  31. Thomsen M, Morling N, Snorrason E, Svejgaard A, Sorensen SF (1979) HLA-Dw4 and rheumatoid arthritis. Tissue Antigens 13: 56–60

    PubMed  Google Scholar 

  32. Toyada K, Saito S, Nato S, Konomi K, Yamamoto H (1977) HLA antigens in classical and malignant rheumatoid arthritis in Japanese population. Tissue Antigens 10: 56

    PubMed  Google Scholar 

  33. Weinblatt M, Coblyn JS, Glass D (to be published) Association of HLA-DRw3 with gold induced thrombocytopenia. Clin Res

  34. Winchester RJ (1977) B-lymphocyte alloantigens, cellular expression, and disease significance with special reference to rheumatoid arthritis. Arthritis Rheum 20: 159

    Google Scholar 

  35. Winchester RJ, Kunkel HG (1979) The human la system. Adv Immunol 28: 221

    PubMed  Google Scholar 

  36. Wooley PH, Griffin J, Panayi GS, Batchelor JR, Welsh KI, Gibson TJ (1980) HLA-DR antigens and toxic reaction to sodium aurothiomalate and D-penicillamine in patients with rheumatoid arthritis. N Engl Med 303: 300

    Google Scholar 

  37. Woolf B (1955) On estimating the relation between blood group and disease. Ann Hum Genet 19: 251

    PubMed  Google Scholar 

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  1. Hospital for Joint Diseases, Mt. Sinai School of Medicine, New York, New York, USA

    R. J. Winchester

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Winchester, R.J. Genetic aspects of rheumatoid arthritis. Springer Semin Immunopathol 4, 89–102 (1981). https://doi.org/10.1007/BF01857089

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