RESEARCH - Association of HLA-C3 and smoking with vasculitis in patients with RA

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Arthritis Rheum. 2006 Aug 31;54(9):2776-2783 [Epub ahead of print]

Association of HLA-C3 and smoking with vasculitis in patients with

rheumatoid arthritis.

Turesson C, Schaid DJ, Weyand CM, sson LT, Goronzy JJ, sson IF,

Dechant SA, Nyahll-Wahlin BM, Truedsson L, Sturfelt G, Matteson EL.

Malmo University Hospital, Malmo, Sweden.

OBJECTIVE: To compare HLA-C genotypes and smoking habits in patients with

vasculitis or other severe extraarticular manifestations of rheumatoid

arthritis (ExRA) with those in RA patients without extraarticular disease.

METHODS: Patients were recruited from a large research database of patients

with RA at the Mayo Clinic, from 2 Swedish cohorts of prevalent RA cases,

and from a regional Swedish early RA cohort. Patients with severe ExRA (n =

159) and control patients with RA but no history of ExRA (non-ExRA controls)

(n = 178) were matched for duration of RA and for clinical center. Data on

smoking at RA onset, rheumatoid factor (RF) status, and antinuclear

antibodies (ANAs) were extracted from the medical records. Polymerase chain

reaction-based HLA-C genotyping was performed using a sequence-specific

primer kit. RESULTS: The distribution of HLA-C alleles was significantly

different between patients with RA-associated vasculitis and non-ExRA

controls (P = 0.014). This was mainly due to a positive association of the

HLA-C3 allele with vasculitis (allele frequency 0.411 in vasculitis patients

versus 0.199 in non-ExRA controls; P < 0.001) and a decreased frequency of

HLA-C7 (0.122 and 0.243, respectively; P = 0.018). The association between

HLA-C3 and vasculitis was not due to linkage disequilibrium with HLA-DRB1.

Smoking (P = 0.001), RF positivity (P < 0.0001), and presence of ANAs (P <

0.0001) were all associated with ExRA. HLA-C3 and smoking were both

significant predictors of vasculitis in a multivariate model.

CONCLUSION: Vasculitis in RA is associated with HLA-C3. Smoking is an

independent predictor of vasculitis and other types of severe ExRA. Our

results suggest that these variables are among the genetic and environmental

factors that contribute significantly to the pathomechanisms of systemic RA.

PMID: 16947780

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

6947780

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Mayo Clinic in Rochester

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s Hopkins Medicine

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