Background Rheumatoid arthritis (RA) is chronic inflammatory disease of synovial tissue that leads to destructive joint damage and disability. An genetic association between particular HLA-DRB1 genes and severity of disease course has been documented in various clinical investigations.1–3
Objectives To investigate HLA-DRB1 distribution in patients with non-erosive and erosive joint disease.
Methods Sixty six patients with nonspecific joint pain and/or arthritis, non-erosive RA and erosive RA were selected. Evaluated parameters were: sex, age, disease duration, tender and swollen joints index (44 joints), functional index (HAQ), ESR, rheumatoid factor, x-ray of hands and feet classified according Larsen score and HLA-DRB1 typing. The presence of one or more susceptible alleles DRB1*0101; *0401; *0404; *0405; *0101 and *1401 was considered as poor prognostic sign.
Results Non-erosive joint disease (Larsen 0-I) was diagnosed in 37 patients (mean disease duration and range: 30/2–132/months) and 29 patients (55/2–216/months) had erosive changes (Larsen II-V). Susceptible alleles were identified in 26 non-erosive and 21 erosive patients. In the whole group the most frequent genes were DRB1*0101 (30 pts.), *0401 (11 pts.) and *0404 (7 pts.). Seven out of 47 DRB1 positive patients had 2 or more susceptible alleles. There were no statistically significant differences between non-erosive and erosive group in any variable.
Conclusion DRB1*0101 is the most frequent susceptible allel in Croatian arthritis population. In this study the prevalence of susceptible genes was almost same in non-erosive and erosive joint disease. Our data do not support evidence for more destructive disease course in DRB1 positive patients.
Emery P, et al. Genetically determined factors as predictors of radiological change in patients with early symmetrical arthritis. BMJ 1992;305:1387–9
O Dell JR, et al. HLA-DRB1 typing in rheumatoid arthritis: predicting response to specific treatment. Ann Rheum Dis. 1998;57:209–13
Rau R, et al. The effect of HLA-DRB1 genes, rheumatoid factor and treatment on radiographic disease progression in rheumatoid arthritis over 6 years. J Rheumatol. 2000;27:2566–75
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