The full content of Annals is available to subscribers

Subscribe/Learn More  >
Editorials |

Excitement—and Confusion—about HLA and Rheumatoid Arthritis

Edward D. Harris Jr., MD
[+] Article, Author, and Disclosure Information

Stanford University School of Medicine, Palo Alto, CA 94304-1808 Requests for Reprints: Edward D. Harris Jr., MD, Stanford University School of Medicine, 1000 Welch Road, Suite 203, Palo Alto, CA 94304-1808.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1995;123(3):232-233. doi:10.7326/0003-4819-123-3-199508010-00012
Text Size: A A A

Rheumatoid arthritis has successfully resisted the efforts of many investigators to find a specific cause of the disease or a single genetic basis for risk. Vigorous debate continues about whether a retrovirus from the environment, an autoantigen from a patient's connective tissues or plasma, or a cross-reactive immune response between host tissues and a superantigen (for example, bacterial heat shock proteins) triggers this disease. Except for a person's recognized high risk for developing rheumatoid arthritis when she or he has an identical twin with the disease [1], there was little evidence for a genetic predisposition until Astorga and Williams [2] reported in 1969 that in 14 of 22 different patients with rheumatoid arthritis, lymphocytes mixed in cultures did not activate each other. These data, which in retrospect implied identical cell membrane antigens in the cells of different patients, attracted little attention until Stastny [3] found that in a cohort of white persons, 68% of patients with rheumatoid arthritis but only 12% of controls shared type Dw4 in the major histocompatibility complex (MHC).

First Page Preview

View Large
First page PDF preview





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $32.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Related Point of Care
Topic Collections
PubMed Articles
[Genetic risk factors for rheumatoid arthritis]. Nihon Rinsho 2016;74(6):897-901.
Immune recognition of citrullinated epitopes. Immunology Published online Jun 29, 2016;
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.