Immunogenetics of rheumatoid arthritis in Israel

In response to the continuing debate as to whether seronegative rheumatoid arthritis (RA) and seropositive RA are part of the same disease spectrum or are distinct disorders, we evaluated 720 patients with definite and classic RA, of whom 53 subjects had definite persistently seronegative destructive disease. For all but 1 seronegative RA patient, a seropositive RA case control was identified and matched for age, disease duration, degree of destruction on hand radiographs, and disease‐modifying drug therapy. DR typing was undertaken on these 105 patients, together with scoring of hand radiographs. The frequency of DR4 was 69% in seropositive RA patients and 60% in seronegative RA patients (P = 0.22), versus 36% in 318 healthy controls (P = 0.008 and P = 0.007 versus seropositive and seronegative RA, respectively). Patients were matched and rematched with different controls in a series of subanalyses in order to make comparisons of hand radiograph scores. We found that HLA–DR4 was associated with destructive RA in both seropositive and seronegative RA patients. In general, DR4+ patients had more severe disease by radiologic criteria than did DR4– patients. Thus, HLA–DR4 may be an additive factor to the serologic status and may be more closely related to disease severity than to disease susceptibility.

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Destructive arthritis, rheumatoid factor, and HLA–DR4. Susceptibility versus severity, a case–control study

Calin

Elswood

Klouda

1989

Arthritis & Rheumatism

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Accelerated nodulosis and vasculitis during methotrexate therapy for rheumatoid arthritis

Segal

Caspi

Tishler

et al. 1988

Arthritis & Rheumatism

109

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Three women with classic rheumatoid arthritis, who were receiving weekly doses of methotrexate (MTX), developed accelerated subcutaneous nodulosis, despite good response to the drug. In 2 of the patients, the onset of nodulosis occurred within 3 months and 5 months, respectively, after starting MTX; in the third patient, it was observed only after 4 years of MTX therapy. In all 3 patients, the onset was unusually abrupt, with extensive distribution and remarkable nodule size. Additional manifestations of cutaneous vasculitis in 2 of the patients and Raynaud's phenomenon in the third appeared concomitantly with the nodulosis. Physicians prescribing MTX therapy for patients with rheumatoid arthritis should be aware of these potential complications.

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HLA–D region antigens in patients with rheumatoid arthritis

McCusker

Reid

Green

et al. 1991

Arthritis & Rheumatism

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We studied the distribution of HLA-D region antigens in 2 groups of rheumatoid arthritis (RA) patients: those with mild, nonprogressive disease, and those with severe disease. The results demonstrate that DR4 was significantly increased in both RA patient populations. The frequencies of DRl and DR4-associated DQw7 alleles, however, were different in these 2 groups of patients. DR1 was significantly increased only in patients with mild RA, and DR4-associated DQw7 was significantly increased only in patients with severe disease. The results of the present study, together with previous data from our laboratory and from other investigators on the incidence of HLA-D region antigens in RA, suggest that both DR and DQ (A and B) genes may be important in conferring susceptibility to RA; DR in the mild forms of the disease, and DQ in severe RA.Rheumatoid arthritis (RA) is a chronic systemic and articular inflammatory disorder of unknown etiology, in which autoimmune mechanisms are currently believed to play a role in the pathogenesis. Disease severity is variable, and it is possible that RA may

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Immunogenetics of rheumatoid arthritis in Israel

Abstract: In an attempt to study the variation of associations between HLA and rheumatoid disease a population of 44 Ashkenazi and 29 non-Ashkenazi patients with Rheumatoid Arthritis were tested for HLA-A, B, C and DR antigens and compared with the relevant control groups.

Cited by 38 publications

References 20 publications

Destructive arthritis, rheumatoid factor, and HLA–DR4. Susceptibility versus severity, a case–control study

Destructive arthritis, rheumatoid factor, and HLA–DR4. Susceptibility versus severity, a case–control study

Accelerated nodulosis and vasculitis during methotrexate therapy for rheumatoid arthritis

HLA–D region antigens in patients with rheumatoid arthritis

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