Molecular mimicry in HLA-B27-related arthritis

Article Abstract:

The joint diseases ankylosing spondylitis (a swelling in the spine) and reactive arthritis (swelling in the joints of the fingers and toes) occur where the ligaments enter bones or between cartilage and bones. Reactive arthritis, which develops suddenly, is thought to be a reaction to the bacterial infection rather than a symptom of the infection itself, and thus antibiotics are ineffective in its treatment. Although bacteria have not been found in spondylitis lesions, it is speculated that Klebsiella pneumoniae is the cause. The histocompatibility antigen HLA-B27, one of the genetically determined antigens that are found on the surfaces of some cells, is found in 90 percent of the patients with ankylosing spondylitis and 60 to 80 percent of the patients with reactive arthritis. However, six percent of the general population also carry these antigens, and therefore the presence of HLA-B27 cannot be used to diagnose these two diseases. It is theorized that patients with these arthritic diseases carry components that are analogous to components comprising the HLA-B27 antigens, of which there are six types. Klebsiella bacterial components have been identified as having six amino acids (smaller components that form a protein) identical to those located in two of the HLA-27B variants. Human proteins with amino acid sequences similar to those of infecting organisms have been thought to cause other diseases (for instance streptococcal infections and rheumatic fever). Knowledge regarding protein mimicry is useful for future research focusing on the pathogenesis of reactive arthritis and ankylosing spondylitis, both presumed to be HLA-27B-associated. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Development and progression, HLA histocompatibility antigens, HLA antigens, Infectious arthritis, Spondyloarthropathies, Ankylosing spondylitis

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Most African-American patients with rheumatoid arthritis do not have the rheumatoid antigenic determinant (epitope)

Article Abstract:

The presence of the rheumatoid epitope seems to have little effect on the severity of rheumatoid arthritis in African-American patients. The rheumatoid epitope is a group of proteins that share some common DNA sequences and cause an immune reaction. Different ethnic populations around the world with rheumatoid arthritis seem to carry unique gene combinations that code for the rheumatoid epitope even though symptoms of the disease are similar. Researchers tested the blood of 86 African-American patients with rheumatoid arthritis and 88 healthy people for the presence of the rheumatoid epitope and the genes that code for it. Nearly two-thirds of the rheumatoid arthritis patients did not carry the genes that code for the rheumatoid epitope. Rheumatoid arthritis patients with and without the rheumatoid epitope had similar clinical symptoms.

Genetic aspects, Rheumatoid arthritis

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The cost-effectiveness of cyclooxygenase-2 inhibitors for treating chronic arthritis

Article Abstract:

A group of drugs called COX-2 inhibitors are not cost-effective for most people with arthritis unless the patient has a history of a bleeding ulcer. COX-2 inhibitors would only be cost-effective for all arthritis patients if they only cost one-tenth what they cost in 2003. Celebrex and Vioxx are both COX-2 inhibitors.

Economic aspects, Drug therapy, COX-2 inhibitors, Arthritis, Cost benefit analysis

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