Abstract
Rheumatoid arthritis (RA) is a chronic heterogeneous autoimmune disorder of unknown etiology. Genetic factors play an important role in susceptibility to RA as the heritability of RA is between 50% and 60%, with the human leukocyte antigen (HLA) locus accounting for at least 30% of overall genetic risk. It is conceivable that there is more than one susceptible gene(s) operative in RA, and an interaction of the relevant genes may predispose the offspring to develop the disease under certain conditions .Outside the major histocompatibility complex (MHC) region, some additional risk loci have been identified and validated including PTPN22, STAT4, PADI4, CTLA4 and others Genetic factors are also important in RA pharmacotherapy due to the gene-dependent activity of enzymes involved in the pharmacokinetics and/or pharmacodynamics of RA medications. Indeed, there is great variability in drug efficacy as well as adverse events associated with any anti-rheumatic therapy and genetics is thought to contribute significantly to this inter-individual variability in response. The ability to screen the entire genome for association to complex diseases has great potential for identifying gene effects. DOI: http://dx.doi.org/10.3329/jom.v13i1.10048 JOM 2012; 13(1): 51-54
Highlights
Rheumatoid arthritis is the most common cause of inflammatory polyarthritis in adults.[1]
Role of human leukocyte antigen (HLA)-DR in rheumatoid arthritis A genetic link between HLA-DR and RA was initially described in the 1970s with the observation that HLA-DR4 occurred in 70% of RA patients compared with about 30% of controls, giving a relative risk of having RA of approximately 4 to 5 to individuals with HLA-DR4.6 Many population studies confirmed the original association with DR4, but as a wider range of populations were studied, a number of interesting findings emerged
2009 showed that anti-tumour necrosis factor therapy has proved to be highly successful in treating rheumatoid arthritis (RA), 30-40% of patients have little or no response, which may be genetically determined
Summary
Rheumatoid arthritis is the most common cause of inflammatory polyarthritis in adults.[1]. Role of HLA-DR in rheumatoid arthritis A genetic link between HLA-DR and RA was initially described in the 1970s with the observation that HLA-DR4 occurred in 70% of RA patients compared with about 30% of controls, giving a relative risk of having RA of approximately 4 to 5 to individuals with HLA-DR4.6 Many population studies confirmed the original association with DR4, but as a wider range of populations were studied, a number of interesting findings emerged. Assistant Professor (OSD-DGHS), Department of Medicine, BSMMU 2.
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