Association of the B-Cell Alloantigen DRw4 with Rheumatoid Arthritis

TLDR

Previous studies showed that HLA‑D type Dw4 is more frequent in rheumatoid arthritis patients than in normal controls, and that related B‑cell alloantigens can now be identified by a simple serologic test. The study tested 80 white patients with erosive, rheumatoid‑factor‑positive rheumatoid arthritis and matched controls for HLA‑A, B, C, and D antigens using the serologic assay. HLA‑DRw4 was present in 70 % of patients versus 28 % of controls, and HLA‑Dw4 in 54 % versus 16 %, indicating a strong association of HLA‑D region genes with rheumatoid arthritis in whites. Published in N Engl J Med 298:869–871 (1978).

Abstract

Previous testing of patients with rheumatoid arthritis showed that one HLA-D type, Dw4, occurred more frequently than in normal controls. B-cell alloantigens closely related to HLA-D can now be identified by a simple serologic procedure. Using this test, I studied 80 white patients with erosive, rheumatoid-factor-positive rheumatoid arthritis. The B-cell alloantigen HLA-DRw4 occurred in 70 per cent of 54 patients, as compared to 28 per cent of the 68 normal controls (P<10–5). Both groups were also tested for the HLA-A, B and C antigens and for HLA-D. HLA-Dw4 occurred in 54 per cent of the patients and 16 per cent of the controls (P<10–5). Small differences observed in several of the HLA-A and B antigens were not statistically significant. The results indicate that rheumatoid arthritis in whites is associated with genes of the HLA-D region and that immunogenetic factors linked to HLA have a role in its pathogenesis. (N Engl J Med 298:869–871, 1978)