To determine the relationship of DR1, DR4, and DR4 subtypes with disease severity in patients with rheumatoid arthritis (RA).
We studied a cohort of 103 Caucasian patients with an onset of disease in 1985, and 6 to 7 years of disease at the time of the study.
Fifty-six patients (54%) were DR4 positive.
A higher risk was observed for DR1/DR4 heterozygotes (OR=6.8 in seropositive patients and OR=1.7 in seronegative patients).
No significant differences were observed in disease activity, joint counts, radiological scores, or functional status among patients carrying 1,2 or no disease related alleles, although the prevalence of rheumatoid factor (RF) showed a linear association with allele dose (0,1, or 2).
DR4 and in particular DR1/DR4 heterozygosity were related to susceptibility to RA only in seropositive patients.
RF was a better predictor of severity than disease related HLA subtypes.
These findings suggest that the effect of these alleles on severity may be related to seropositivity, or that perhaps, seropositive and seronegative RA are genetically distinct entities.
The results of our study suggest that in community based settings, which include patients with milder disease, DRI and DR4 disease related alleles increase susceptibility for RA, but are not clinically useful as predictors of longer term outcome.
Mots-clés Pascal : Polyarthrite rhumatoïde, Chronique, Maladie autoimmune, Rhumatisme inflammatoire, Immunopathologie, Système ostéoarticulaire pathologie, Epidémiologie, Homme, Système histocompatibilité majeur, Système HLA-DR, Alberta, Canada, Amérique du Nord, Amérique, Evolutivité, Antigène histocompatibilité classe II, Phénotype, Etude cohorte
Mots-clés Pascal anglais : Rheumatoid arthritis, Chronic, Autoimmune disease, Inflammatory joint disease, Immunopathology, Diseases of the osteoarticular system, Epidemiology, Human, Major histocompatibility system, HLA-DR-System, Alberta, Canada, North America, America, Evolutivity, Class II histocompatibility antigen, Phenotype, Cohort study
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0027468
Code Inist : 002B15D. Création : 01/03/1996.