Abstract

IntroductionThis study investigated five confirmed rheumatoid arthritis (RA) susceptibility genes/loci (HLA-DRB1, PTPN22, STAT4, OLIG3/TNFAIP3 and TRAF1/C5) for association with susceptibility and severity in an inception cohort.MethodsThe magnitude of association for each genotype was assessed in 1,046 RA subjects from the Yorkshire Early RA cohort and in 5,968 healthy UK controls. Additional exploratory subanalyses were undertaken in subgroups defined by autoantibody status (rheumatoid factor and anti-cyclic citrullinated peptide) or disease severity (baseline articular erosions, Health Assessment Questionnaire (HAQ) score and swollen joint count (SJC)).ResultsIn the total RA inception cohort, the HLA-DRB1 shared epitope (per-allele odds ratio (OR) = 2.1, trend P < 0.0001), PTPN22 (per-allele OR = 1.5, trend P < 0.0001), OLIG3/TNFAIP3 locus (per-allele OR = 1.2, trend P = 0.009) and TRAF1/C5 locus (per-allele OR = 1.1, trend P = 0.04) were associated with RA. The magnitude of association for these loci was increased in those patients who were autoantibody-positive. PTPN22 was associated with autoantibody-negative RA (per-allele OR = 1.3, trend P = 0.04). There was no evidence of association between these five genetic loci and baseline erosions or SJC in the total RA cohort, after adjustment for symptom duration. TRAF1/C5 was significantly associated with baseline HAQ, however, following adjustment for symptom duration (P trend = 0.03).ConclusionsThese findings support the mounting evidence that different genetic loci are associated with autoantibody-positive and autoantibody-negative RA, possibly suggesting that many of the genes identified to date are associated with autoantibody production. Additional studies with a specific focus on autoantibody-negative RA will be needed to identify the genes predisposing to this RA subgroup. The TRAF1/C5 locus in particular warrants further investigation in RA as a potential disease severity locus.

Highlights

  • This study investigated five confirmed rheumatoid arthritis (RA) susceptibility genes/loci (HLA-DRB1, protein tyrosine phosphatase nonreceptor 22 gene (PTPN22), STAT4, OLIG3/TNFAIP3 and TRAF1/C5) for association with susceptibility and severity in an inception cohort

  • The present study focuses on five confirmed RA susceptibility genes/loci HLA-DRB1 (6p21), PTPN22 (1p13), OLIG3/TNFAIP3 (6q23), STAT4 (2q32) and TRAF1/C5 (9q33) - that are associated with RA with low-to-moderate risk in UK patients [6,7,8]

  • Additional exploratory subanalyses were undertaken to explore whether any positive findings were associated with a specific subgroup defined by autoantibody status or disease severity

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Summary

Introduction

This study investigated five confirmed rheumatoid arthritis (RA) susceptibility genes/loci (HLA-DRB1, PTPN22, STAT4, OLIG3/TNFAIP3 and TRAF1/C5) for association with susceptibility and severity in an inception cohort. The present study focuses on five confirmed RA susceptibility genes/loci HLA-DRB1 (6p21), PTPN22 (1p13), OLIG3/TNFAIP3 (6q23), STAT4 (2q32) and TRAF1/C5 (9q33) - that are associated with RA with low-to-moderate risk in UK patients [6,7,8]. Many of the RA susceptibility genes identified to date appear to only be significant in the autoantibody-positive cohorts, this may be secondary to the increased statistical power in this more prevalent patient subgroup [13] If confirmed, this observation may suggest that these loci are influencing susceptibility to autoantibody production, perhaps through the loss of self-tolerance, explaining their association with multiple autoimmune disorders. Unravelling the stage in the disease process in which these genes exert their maximum influence on RA pathogenesis will be necessary to fully unveil their clinical significance and reveal those pathways that are potential therapeutic targets or may become clinically useful biomarkers

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