@article{11189,
  keywords = {Arthritis, Rheumatoid, Disease Susceptibility, Genetic Markers, HLA-D Antigens, HLA-DR Antigens, HLA-DR4 Antigen, Humans, Immunoglobulin Allotypes, leprosy},
  author = {Jongh B M and Westedt M L and Vries R R and Valkenburg H A and Cats A},
  title = {Genetic heterogeneity of rheumatoid arthritis.},
  abstract = {<p>In a population survey in The Netherlands we investigated 6584 individuals for the presence of rheumatoid diseases and their determinants. We observed no overall association of rheumatoid arthritis (RA) with HLA-DR4 or GM. This result is in contrast to the marked association of HLA-DR4 with RA found in studies based mainly on hospital rheumatology clinics. The findings thus suggest a genetic basis for the disease heterogeneity. A study of 16 multicase RA families showed a co-segregation of RA with the DR4 carrying haplotype from the unaffected parent, whereas the non-DR4 haplotype was preferentially segregating to the healthy siblings (p = 0.001). These data suggest that HLA-DR4 is associated with disease susceptibility rather than with a disease modifying factor. In a further attempt to define a genetic basis for disease heterogeneity we compared five well-defined clinical groups of patients with RA. Although the frequency of HLA-DR4 was significantly elevated in all patient groups as compared to healthy controls, we observed a preferential association of HLA-DR4 with severe extra-articular manifestations as compared to patients without extra-articular manifestations (p = 0.002). These results provide an immunogenetical basis for the disease heterogeneity observed in RA and further extend the immunological analogy between RA and leprosy.</p>},
  year = {1986},
  journal = {Disease markers},
  volume = {4},
  pages = {29-33},
  month = {1986 Jun},
  issn = {0278-0240},
  language = {eng},
}