Influence of HLA-DR alleles on rheumatoid arthritis: Susceptibility and severity in Argentine patients

Objective. To determine the frequency of shared epitopes in our population of patients with rheumatoid arthritis (RA) and to investigate whether the presence of these alleles is associated with a more aggressive form of disease. Methods. Demographic and clinical data were obtained from 140 patients...

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Detalles Bibliográficos
Autores principales: Citera, G., Padulo, L.A., Fernandez, G., Lazaro, M.A., Rosemffet, M.G., Maldonado Cocco, J.A.
Formato: JOUR
Materias:
Disease severity
HLA-DR alleles
Rheumatoid arthritis
Shared epitope
epitope
HLA DR antigen
HLA DR11 antigen
HLA DR3 antigen
HLA DR4 antigen
unclassified drug
adult
aged
allelism
Argentina
article
controlled study
disease duration
disease predisposition
disease severity
female
hand radiography
human
major clinical study
male
polymerase chain reaction
priority journal
rheumatoid arthritis
scoring system
Adult
Aged
Alleles
Arthritis, Rheumatoid
Epitopes
Female
Genetic Predisposition to Disease
Genotype
HLA-DR Antigens
HLA-DR3 Antigen
Humans
Male
Middle Aged
Severity of Illness Index
Acceso en línea:http://hdl.handle.net/20.500.12110/paper_0315162X_v28_n7_p1486_Citera
Aporte de:
Biblioteca Digital - Facultad de Ciencias Exactas y Naturales (UBA) de Universidad de Buenos Aires
Descripción
Sumario:Objective. To determine the frequency of shared epitopes in our population of patients with rheumatoid arthritis (RA) and to investigate whether the presence of these alleles is associated with a more aggressive form of disease. Methods. Demographic and clinical data were obtained from 140 patients with RA, 123 female, mean age 49.9 ± 11.7 years and mean disease duration 9.4 ± 6.3 years. Radiographs of both hands were taken and scored by Larsen's method. HLA-DR alleles were determined by PCR-SSP. The control group comprised 202 healthy ethnic-matched subjects. Results. DR4 was significantly more frequent in patients with RA than controls, and was observed in 70/140 patients (50%) versus 47/202 controls (23.27%) (odds ratio 3.25, CI 1.99-5.35, Pcorr 5 × 10-5). Within DR4 subtypes *0404 and *0401 were the most commonly found (37.7 and 29%, respectively). DR3 and DR11 exerted a protective effect with significantly higher frequency in controls than in patients with RA. When patients were divided into 2 groups according to disease severity (radiographic score) the frequency of alleles with QKRAA and QRRAA sequences was similar in both groups. Although with lower frequency, subtype *1001 alone was significantly more frequent in the severe-condition group [7 (13.5 %) vs 3 (3.4 %), p = 0.03]. Conclusion. These results are in accordance with findings observed in Caucasians and differ from other Latin American populations. However shared epitope alleles failed to correlate with more severe disease with the exception of subtype *1001 which, although infrequent, was significantly more frequent in patients with relevant radiological damage.

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