D. Olga McDaniel; Graciela S. Alarcon; Parks W. Pratt; John D. Reveille
To evaluate the relation between the presence of the “rheumatoid epitope,” defined by a sequence motif in the HLA-DRB1 alleles, and disease severity in African-American patients with rheumatoid arthritis.
Rheumatology outpatient clinics at two university medical centers.
86 African-American patients with rheumatoid arthritis (66 seropositive and 20 seronegative for the rheumatoid factor) attending the clinics and 88 healthy African-American persons.
HLA-DRB1 alleles were determined by restriction fragment length polymorphism and by allele-specific oligonucleotide typing of polymerase chain reaction-amplified HLA-DRB1 second exons.
With the exception of an increased frequency of HLA-DRB1*04 alleles in seropositive patients with rheumatoid arthritis (27.3%) compared with controls (13.1%) (P = 0.02), the frequencies of HLA-DRB1 alleles were similar in patients and controls. Most seropositive (48 of 66) and seronegative (15 of 20) patients were HLA-DR4 negative, but some (7 of 48 seropositive patients and 3 of 15 seronegative persons) inherited the rheumatoid epitope on a non-DR4 allele. Disease features, including severity, were similar for patients without the epitope and for those with either a single or a double dose of an epitope-positive allele. Positivity for rheumatoid factor, but not for the rheumatoid epitope, was weakly associated with severity in these patients.
Most African-American patients with rheumatoid arthritis did not express the rheumatoid epitope. The predisposition to and severity of rheumatoid arthritis in African-Americans appears to be independent of the presence and dose of the shared rheumatoid epitope.
D. Olga McDaniel, Graciela S. Alarcon, Parks W. Pratt, John D. Reveille. Most African-American Patients with Rheumatoid Arthritis Do Not Have the Rheumatoid Antigenic Determinant (Epitope). Ann Intern Med. 1995;123:181–187. doi: 10.7326/0003-4819-123-3-199508010-00004
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Published: Ann Intern Med. 1995;123(3):181-187.
Rheumatoid Arthritis, Rheumatology.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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