Role of Rheumatoid Factor B Cells in Normal and Pathologic Antigen Presentation 英文参考文献.docVIP
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Abstracts
Abstracts presented at the Fourth International Synovitis Workshop
Dallas, Texas, 21–25 April 1999
Peter E Lipsky (Organizer), Simmons Arthritis Research Center
Genetics of Rheumatoid Arthritis
Genetics of Rheumatoid Arthritis
than 4 years, and 87 patients were seen for 2 years. Significant
associations with progressive joint destruction, measured by the
Larsen index, were observed after 2 and 4 years for three
parameters: 1) the presence of rheumatoid factor IgM; 2) bony
erosions present at study entry, and 3) HLA DRB1 markers.
Patients who expressed the shared epitope on a DR4 allele had
significantly higher Larsen indices after 2 years (0.86 vs 0.12;
P=0.0015) and after 4 years (1.22 vs 0.53; P=0.002) of
disease duration. Similarly, the presence of the epitope
sequence on either DR1 or DR4 also resulted in higher Larsen
indices for epitope-positive patients (0.59 vs 0.06; P=0.006
after 2 years, and 1.0 vs 0.69; P=0.03 after 4 years). A more
severe radiologic outcome after 2 years (Larsen index 0.7)
was detected with a sensitivity of 0.7, 0.61, and 0.58 and a
specificity of 0.42, 0.84 and 0.75 using RF IgM, erosiveness at
initial presentation, and presence of the shared epitope on a
DR4 as prognostic parameters. Most useful, however, was the
combination of DR4 positivity and erosiveness at study entry as
prognostic indicators of a more severe course of joint
destruction (sensitivity 0.68; specificity 0.77).
Gerald T Nepom
Virginia Mason Research Center, Seattle, Washington, USA
Genetic associations between rheumatoid arthritis and specific
HLA class II genes provide clues to understanding the
molecular basis for disease susceptibility. There is a remarkable
structural relationship among different rheumatoid arthritis (RA)
susceptibility genes, in which each of the associated class II
alleles encodes a sequence
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