Despite large efforts, the genetic and environmental factors that cause rheumatoid arthritis (RA) have not been found. The only significant genetic clue today is an association with the major histocompatibility complex (MHC) region coding for class II peptide receptors, which are known to be crucial for immune responses. However, the MHC region only partially reflects the genetic influence as this is a polygenically controlled disease. In addition environmental factors are likely to strongly influence the disease. One such important environmental factors are adjuvants, derived from pathogenic organism or from other exogenous and endogenous sources.
These complex issues are better clarified in animal models. In fact there are mainly two ways to induce arthritis in rodents.
Firstly, injection of various adjuvants trigger arthritis in certain rat strains.1,2,3 The properties of these adjuvants are that they are difficult to degrade in vivo and are soluble in cellular membranes. In contrast to antigens they do not bind to MHC molecules and can therefore not elicit an antigen specific response. Nevertheless, adjuvants trigger an arthritic disease which in certain cases closely mimics RA(3). One of the best models is pristine induced arthritis (PIA) which is a MHC class II dependent, ab T cell dependent chronic relapsing disease.3,4,5 It can be prophylactically and therapeutically vaccinated against with the help of joint specific antigens.6
Secondly, immunisation with joint-specific proteins may induce arthritis. In this case fragments of the protein bind to MHC molecules and elicit an immune response cross-reactive with joint antigens.7,8,9 Subsequently the joints are attacked and may develop into a chronic relapsing disease depending on the specificity of the immune response and the genetics of the strain. Examples of joint antigen specific models are type II collagen induced arthritis (CIA) and cartilage oligomeric matrix protein-induced arthritis (COMPIA).10,11,12
Genetic analyses of adjuvant and joint specific models show that most, but not all, genetic regions are shared indicating that they share pathogenic mechanisms. These models will be further discussed mainly based on genetic dissection of MHC and non-MHC genetic regions.
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