Rheumatoid arthritis in American Indians and Alaska Natives: A review of the literature

doi:10.1016/j.semarthrit.2004.08.003

Seminars in Arthritis and Rheumatism

Volume 34, Issue 4, February 2005, Pages 662-667

https://doi.org/10.1016/j.semarthrit.2004.08.003 Get rights and content

Background and objectives

An increased prevalence of rheumatoid arthritis (RA) has been reported in several American Indian and Alaska Native (AI/AN) populations. This article reviews the prevalence of RA in these populations, including clinical and serologic features.

Methods

References were taken from Medline through November 2003, in addition to the Arctic Health Literature Database and the American Indian and Alaska Native Health Bibliography.

Results

Published articles reveal an increased prevalence of RA in the Tlingit, Yakima, Pima, and Chippewa Indians. Clinically the disease in these groups is often severe, with early age of onset, high frequency of radiographic erosions, rheumatoid nodules, and positive rheumatoid factor. Studies of HLA alleles in cases and controls have found a high frequency of HLA DRB1*1402.

Conclusions

The increased prevalence of RA and more severe disease in specific AI/AN populations suggest an important genetic influence on the development of RA in AI/AN populations. A high frequency of specific high-risk HLA alleles in these populations may account for some of the increased risk, but other genetic factors are likely to contribute. Environmental factors have not been studied in detail, but may also play an important role.

Relevance

Understanding the patterns and burden of disease in AI/AN populations may contribute to understanding the etiology of RA and to the development of preventive strategies.

Section snippets

Methods

This review is based on a Medline literature search from 1966 through November 2003, using the keywords “rheumatoid arthritis,” “American Indian,” and “Alaska Native.” Articles obtained were reviewed for additional references. In addition, the Arctic Health Publications Database, a reference maintained by the University of Alaska Anchorage Health Sciences Information Services and the National Library of Medicine, accessible at www.arctichealth.org, was searched for further references to

Prevalence and incidence of RA in AI/AN populations

Although there is not universal agreement as to the history of migration into North America, a prevailing theory suggests that there were 3 major waves of migration from Siberia across the Bering land bridge (27). In present day Siberia, no particular population, with the exception of some Asian Eskimos, is believed to be directly descended from the American founder populations (28). The first group to cross the Bering land bridge was the Amerinds, who populated North, Central, and South

Discussion

There is an increased prevalence of RA in the Tlingit, Yakima, Pima, and Chippewa Indians, which may provide important clues to the etiology of RA, possibly leading to the development of preventive measures. In addition, there are certain populations known to have lower rates of RA, including those in China, Japan, northwest Greece, and rural Africa (2, 3, 4, 5). Both genetic and environmental factors are postulated to influence the development of RA, and the population variation suggests the

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Rheumatoid arthritis in American Indians and Alaska Natives: A review of the literature

Background and objectives

Methods

Results

Conclusions

Relevance

Section snippets

Methods

Prevalence and incidence of RA in AI/AN populations

Discussion

Semin Arthritis Rheum

Semin Arthritis Rheum

Rheum Dis Clin N Am

Rheum Dis Clin N Am

Semin Arthritis Rheum

Semin Arthritis Rheum

Am J Hum Genet

Hum Immunol

Hum Immunol

Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States

Arthritis Rheum

Rheumatic diseases in ChinaILAR-China study comparing the prevalence of rheumatic symptoms in northern and southern rural populations

J Rheumatol

Changes in the incidence and prevalence of rheumatoid arthritis in Kamitonda, Wakayama, Japan, 1965–1996

Ann Rheum Dis

Epidemiology of adult rheumatoid arthritis in northwest Greece, 1987–1995

J Rheumatol

Rheumatic diseases in Alaskan Indians of the Southeast coasthigh prevalence of rheumatoid arthritis and systemic lupus erythematosus

J Rheumatol

High prevalence of rheumatoid arthritis in Yakima Indians

Arthritis Rheum

High incidence and prevalence of rheumatoid arthritis in Pima Indians

Am J Epidemiol

Rheumatoid arthritis in a Chippewa Band. I. Pilot screening study of disease prevalence

Arthritis Rheum

Rheumatoid arthritis in a Chippewa Band

II. Field study with clinical serologic and HLA-D correlations. J Rheumatol

Prevalence of rheumatoid arthritis in circumpolar native populations

J Rheumatol

Epidemiology and genetics of rheumatoid arthritis

Arthritis Res

The shared epitope hypothesis

An approach to understanding the molecular genetics of susceptibility to rheumatoid arthritis. Arthritis Rheum

The contribution of HLA to rheumatoid arthritis

Clin Genet

Poygenic susceptibility in rheumatoid arthritis

Ann Rheum Dis