REVIEW - Genetics of bone loss in RA - role of vitamin D receptor polymorphisms

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Rheumatology Advance Access first published online on January 16, 2009

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Review

Genetics of bone loss in rheumatoid arthritis—role of vitamin D

receptor polymorphisms

P. Ranganathan1

1 Department of Medicine, Division of Rheumatology, Washington

University School of Medicine, St Louis, MO, USA

Abstract

RA is a systemic inflammatory arthritis that leads to local and

systemic bone loss. Osteoporosis or the systemic bone loss associated

with RA increases the risk for fragility fractures, which can affect

quality of life dramatically in RA patients. Although traditional and

RA-related risk factors have been defined and studied for osteoporosis

associated with RA, genetic factors such as polymorphic variants in

the traditional candidate genes for osteoporosis, such as the vitamin

D receptor (VDR), type 1 collagen A1 (COLIA1) and oestrogen receptor-

(ESR1), have not been well elucidated in RA patients. This review

summarizes the currently available literature on the association of

VDR polymorphisms with local and systemic bone loss in RA. It also

discusses potential targets for genetic research in this area, such as

polymorphisms in genes, such as IL-6 (IL6) and TNF receptor type 2

(TNFRSF1B), which control the inflammatory response in RA and may

influence bone loss in RA. Defining such genetic factors, in addition

to traditional and RA-related risk factors for osteoporosis in RA, may

facilitate early identification of patients at high risk for fractures

who can then be targeted for treatment.

http://rheumatology.oxfordjournals.org/cgi/content/abstract/ken473v2?papetoc

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