Shared epitopes and rheumatoid arthritis: Disease associations in Greece and meta-analysis of Mediterranean European populations*,**
Section snippets
Patients and controls
A total of 174 patients with RA were enrolled in this study. Patients were observed at the Rheumatology Clinic of the University Hospital, University of Ioannina (n = 96) and at the Department of Pathophysiology, University of Athens (n = 78). Patients enrolled at the 2 sites were expected to have fairly similar genetic backgrounds. All patients fulfilled at least 4 of the American College of Rheumatology Criteria for RA (15) and had a disease duration of more than 1 year. One hundred and three
Study population
A total of 174 patients with RA (26 men, 148 women) were typed, 131 of whom had RF. The mean disease duration was 10.5 years (median, 9.5 years; interquartile range [IQR], 5-13). The mean and median age at RA onset was 47.5 and 48 years, respectively (IQR, 40-57). The median Larsen scores were 52 (IQR, 32-75) for total score, 36 (IQR, 21-55) for hands (including wrists), and 14 (IQR, 8-21) for feet. Rheumatoid nodules were recorded in 20 patients, secondary SS in 57 patients, ACD in 45
Discussion
Our study is the largest study of HLA associations of RA conducted in Greece and one of the largest worldwide. It confirms that SE alleles are observed in about half of Greek patients with RA. SE dose is associated with the development of articular damage, and there is an interesting interaction between SE dose and disease duration. In our population in which RA was remarkably mild, SE alleles were not related to the frequency of any carefully defined extra-articular manifestations among
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Cited by (34)
Rheumatoid arthritis
2010, Best Practice and Research: Clinical RheumatologyCitation Excerpt :However, more than half of the heritability of this disease remains without explanation [81,82]. Aetiological hypotheses related to gene-environment interactions are far more plausible [83–85], and may underlie the association of different genotypes in different geographical and cultural settings [86]. Other risk factors may be held in common with other auto-immune diseases.
Extra-articular manifestations and complications of rheumatoid arthritis
2007, Best Practice and Research: Clinical RheumatologyCitation Excerpt :A higher risk of vasculitis was reported in RA patients who carried two HLA DRB1 susceptibility genes [odds ratio (OR) 3].29 In contrast to this, a meta-analysis of Mediterranean European populations concluded that shared epitope (SE) alleles determine articular destruction without increasing the risk of ExRA manifestations.34 In one study, cervical spine subluxation was related to HLA DR2 and HLA B2735, and this feature of RA was more likely but not exclusive to patients with peripheral erosive disease.36
Incidence and Prevalence of Rheumatoid Arthritis, Based on the 1987 American College of Rheumatology Criteria: A Systematic Review
2006, Seminars in Arthritis and RheumatismCitation Excerpt :In addition, some of these studies are based on relatively small sample sizes. It has been suggested that RA in southern Europe has a particular genetic, epidemiological, and clinical profile (35-39). Some studies indicate that RA is milder, with less extra-articular and radiological manifestations in south European populations.
Epidemiology of adult rheumatoid arthritis
2005, Autoimmunity ReviewsFrom genetics to proteomics: How to assess complexity in rheumatoid arthritis?
2004, Revue du Rhumatisme (Edition Francaise)
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Supported by a grant from E.C. concerted action BIOMED 2 (No. BMHH-CT96-0087 [DG 12-SS MA]).
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Address reprint requests to Alexandros A. Drosos, MD, FACR, Professor of Medicine/Rheumatology, Department of Internal Medicine, Medical School, University of Ioannina, 45110 Ioannina, Greece. E-mail: [email protected]