HLA–DR4 subtypes in new zealand polynesians. predominance of dw13 in the healthy population and association of dw15 with rheumatoid arthritis

Tan, Paul; Farmiloe, Sarah; Roberts, Maurice; Geursen, Arie; Skinner, Margot A.

doi:10.1002/art.1780360104

Cited by 21 publications

(7 citation statements)

References 18 publications

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“…The fact that DRB1 *0403 was the most prevalent DR4 subtype in controls could account for the weak association of the disease with DR4 and for the relatively lower RA prevalence (0.1-0.5%) found in Chile12 (Riedemann P, personal communication). This inference is similar to that made previously in New Zealand Polynesians 13. Allelic combinations involving *0401/*0401 or *0401/*0404, which are strongly associated with RA severity,2 3 14 were present in seven (5%) of our patients and in none of the controls.…”

Section: Discussionsupporting

confidence: 92%

Influence of the HLA-DRbeta shared epitope on susceptibility to and clinical expression of rheumatoid arthritis in Chilean patients

González

Nicovani

Massardo

et al. 1997

Annals of the Rheumatic Diseases

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Objective-To analyse the influence of shared epitope positive HLA-DRB1 alleles (QKRAA or QRRAA) ) on rheumatoid arthritis (RA) susceptibility and severity in Chileans, a population that exhibits a weak association with HLA-DR4. Methods-Prevalence of alleles DRB1*01 and DRB1*04 alleles was determined by polymerase chain reaction amplification and sequence specific oligonucleotide hybridisation in 129 RA patients with defined clinical features and in 97 healthy controls. Results-The shared epitope was found in 70 (54%) of the RA patients and in 29 (30%) of controls (odds ratio (OR) =3; 95% confidence intervals (CI) = 1.5, 5.1; p = 0.0004), and was present in a double dose in 20% of patients versus 4% of controls (OR = 6; 95% CI = 2, 21; p = 0.0009). HLA-DRB1*0403 was the most prevalent DR4 subtype in controls (19%). HLA-DRB1*0404 or *0408 were the alleles most prominently associated with RA, 19% versus 6 % in controls (OR=3; 95% CI = 1.3, 10; p = 0.01). The risk of RA in those carrying a double dose of the shared epitope was 7.5 times that seen in patients lacking the epitope. Disease severity was moderate: 33% had extra-articular manifestations. The double dose was associated with an increased risk of vasculitis or extra-articular manifestations. However, 59 patients (46%) did not carry the shared epitope and 18 of them (31%) had extra-articular manifestations. Conclusions-The weak association of RA with DR4 in Chileans seems to relate to a relatively high frequency of the DRB1*0403 allele among DR4 subtypes. As in other populations, the shared epitope in double dose is associated with RA development, especially in its more severe forms. However, both development and expression of severe forms of the disease were independent of the shared epitope in a high proportion of patients, thus emphasising the genetic heterogeneity of the disease and the possible involvement of other genetic elements.

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Section: Discussionsupporting

confidence: 92%

Influence of the HLA-DRbeta shared epitope on susceptibility to and clinical expression of rheumatoid arthritis in Chilean patients

González

Nicovani

Massardo

et al. 1997

Annals of the Rheumatic Diseases

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“…36 This compares with control data from a previous study from our institution that revealed shared epitope positive HLA-DRB*01/*04 alleles in 40% of white subjects and 26% of Polynesians within a New Zealand population 36. We found no significant difference in carriage of the shared epitope between those with MR erosions (82.4%) and those without (69.6%).…”

Section: Discussionsupporting

confidence: 55%

Magnetic resonance imaging of the wrist in early rheumatoid arthritis reveals a high prevalence of erosions at four months after symptom onset

McQueen

Stewart

Crabbe

et al. 1998

Annals of the Rheumatic Diseases

389

287

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Objectives-To evaluate the role of magnetic resonance imaging (MRI) of the wrist in detecting early joint damage in patients with rheumatoid arthritis (RA). Methods-MRI was performed on 42 patients with early RA (median symptom duration of four months). Scans were scored separately by two musculoskeletal radiologists using a newly devised scoring system, which was validated. MRI findings were compared with plain radiography, clinical measures, and HLA-DRB*01/04 genotyping. Results-Interobserver reliability for the overall MRI score was high (r = 0.81) as was intraobserver reliability (r = 0.94 for observer 1 and 0.81 for observer 2). There was more variation in scoring synovitis (interobserver reliability: r = 0.74). Erosions were detected in 45% of scans (19 of 42), compared with 15% of plain radiographs. The most common site for erosions was the capitate (39%), for synovitis the ulnar aspect of the radiocarpal joint, and for tendonitis, the extensor carpi ulnaris tendon. The total MRI score and MRI synovitis score correlated most significantly with C reactive protein (r = 0.40 and 0.42 respectively, p<0.01). The MRI erosion score was highly correlated with MRI bone marrow oedema (r = 0.83) as well as the Ritchie score and disease activity score (r = 0.32, p<0.05). HLA-DRB1*04 or *01 (shared epitope +ve) was found in 76% of patients; 84% of those with MRI erosions and 69% of those without (NS, p = 0.3). Conclusions-A high proportion of RA patients develop MRI erosions very early in their disease, when plain radiography is frequently normal. MRI of the dominant wrist may identify those requiring early aggressive treatment.

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“…The introduction of DNA typing to HLA typing elucidated the role of HLA in the pathogenesis of RA. HLA-DRB1*0401, DRB1*0404, DRB1*0405 and DRB1*0408 were reported to be associated with RA in Caucasian populations [7, 53, 54, 55]and DRB1*0405 in Japanese [56], Taiwanese [57], Korean [8], Israeli [58], New Zealand-Polynesian [59]and Spanish [12]populations. DRB1*0402 and DRB1*0403 have never been reported to be associated with RA in any ethnic group.…”

Section: Discussionmentioning

confidence: 99%

Association between HLA-DRB1*15 and Japanese Patients with Rheumatoid Arthritis Complicated by Renal Involvement

Tokunaga¹,

Noda²,

Kaneoka³

et al. 1999

Nephron

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We performed serological phenotyping of HLA antigens in 175 patients with rheumatoid arthritis (RA) with (n = 41) and without (n = 134) renal involvement (RI), and DNA typing of HLA class II alleles in 75 patients. Among the patients with RA, the frequency of serologically determined HLA-DR4 was found to be significantly increased (odds ratio: 1.8, confidence interval: 1.3–2.5, p = 2.4×10^–4). In the patients without RI, the frequency of serological DR4 significantly increased (odds ratio: 2.2, confidence interval: 1.6–3.3, p = 2.6×10^–5). On the other hand, among the patients with RI, a serological determinant, DR15, did significantly increase (odds ratio: 2.7, confidence interval: 0.9–8.4, p = 1.2×10^–3) in comparison to the controls. At the DNA level, we found that the association of Japanese RA patients with serological HLA-DR4 was based on that with a genotype of HLA-DRB1*0405 (odds ratio: 2.4, confidence interval: 1.5–4.0, p = 4.4×10^–4) and also found an association of HLA-DRB1*1501 (odds ratio: 2.8, confidence interval: 1.2–6.6, p = 0.017) with RA patients having RI. Our results confirmed the association of HLA-DRB1*04 with RA over the ethnic barrier at the DNA level. Our results also suggested a distinct genetic effect of HLA-DRB1*1501 in the aspect of the susceptibility of RI in RA.

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HLA–DR4 subtypes in new zealand polynesians. predominance of dw13 in the healthy population and association of dw15 with rheumatoid arthritis

Cited by 21 publications

References 18 publications

Influence of the HLA-DRbeta shared epitope on susceptibility to and clinical expression of rheumatoid arthritis in Chilean patients

Influence of the HLA-DRbeta shared epitope on susceptibility to and clinical expression of rheumatoid arthritis in Chilean patients

Magnetic resonance imaging of the wrist in early rheumatoid arthritis reveals a high prevalence of erosions at four months after symptom onset

Association between HLA-DRB1*15 and Japanese Patients with Rheumatoid Arthritis Complicated by Renal Involvement

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