The familial nature of rheumatoid arthritis

Article Abstract:

A genetic or hereditary basis for rheumatoid arthritis (RA) has been suggested almost from the time when the disease was first characterized. Many physicians treat families with several affected members. However, studies of larger populations of RA patients have found only weak indications of a tendency for the disease to be inherited. These contradictory findings thus leave many questions about the genetic basis of RA unanswered. Some uncertainties may arise regarding the significance of the two types of studies performed (those looking for genetic markers in affected families and those examining family patterns in larger groups), the methods used to treat RA, for which varied criteria are available, and the age of study subjects, i.e. the increase in prevalence of the disease over time. Studies of families and of twins have suggested that a genetic contribution to RA is low, with familial occurrence being as attributable to the common incidence of the disease as well as similar environments among family members. There are some families who have affected members much more frequently, though, and for these people, this conclusion may be false. More is understood of the familial features of insulin-dependent diabetes mellitus (IDDM), because the inheritance is stronger, the disease occurs earlier, and it has more severe consequences. To better understand the effects in the rare, severely affected families with RA, the findings of susceptibility to IDDM and to RA, as indicated by similar inheritances of histocompatibility antigens (HLA, proteins present on all cells which identify cells as belonging to the host, and which tend to be associated with development of certain diseases) are reviewed and compared. HLA factors may influence the extent of RA severity as well as its occurrence. Non-HLA genes may also be important, as is female sex, although the underlying cause by which gender influences RA development, whether directly through the X chromosome or by other mechanisms, is unclear. Much more research on the molecular basis of inherited tendencies to develop RA remains to be done. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research

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Rheumatoid arthritis, HLA identity, and age at menarche

Article Abstract:

Women who are older at the onset of menstruation may have a higher risk of developing rheumatoid arthritis (RA) later in life than other individuals. RA is a chronic inflammatory disease that affects the joints. Among 98 pairs of sisters, 36 had identical histocompatibility locus antigen (HLA) types and 62 did not. One sister in each pair had RA. The sisters with RA began menstruating at an older age than the sisters without RA. Sisters with identical HLA antigen types started menstruation at approximately the same age, but sisters with non-identical HLA antigen types started at different ages. The sister with RA started at a later age than the one without RA. Female sex hormones may play an important role in the development of RA. The risk of developing RA is three times higher in women than in men.

Health aspects, Risk factors, Menstruation

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Linkage of rheumatoid arthritis with HLA

Article Abstract:

Sharing the same HLA linked genes may increase the risk of rheumatoid arthritis (RA) only in siblings of patients with a severe form of the disease. RA is an inflammatory disease that affects the joints. A genetic analysis was done of 240 sets of siblings and RA patients. Seventy-nine patients had severe RA, and 161 had moderate RA. The risk of RA was higher in siblings of patients with severe RA who shared two HLA linked genes. The risk of RA was the same for siblings of patients with moderate RA regardless of the number of shared HLA linked genes. HLA linked genes may play a more important role in determining the severity of RA rather than genetic predisposition.

Physiological aspects

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