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Báo cáo y học: " Advances in the genetics of rheumatoid arthritis point to subclassification into distinct disease subsets"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Advances in the genetics of rheumatoid arthritis point to subclassification into distinct disease subsets. | Available online http arthritis-research.eom content 10 2 205 Review Advances in the genetics of rheumatoid arthritis point to subclassification into distinct disease subsets Annette HM van der Helm-van Mil and Tom WJ Huizinga Department of Rheumatology Leiden University Medical Center PO Box 9600 2300RC Leiden The Netherlands Corresponding author Annette HM van der Helm-van Mil AvdHelm@lumc.nl Published 31 March 2008 This article is online at http arthritis-research.com content 10 2 205 2008 BioMed Central Ltd Arthritis Research Therapy 2008 10 205 doi 10.1186 ar2384 Abstract In the past few years considerable advances have been made in the genetics of susceptibility to rheumatoid arthritis RA . For decades the HLA-DRB1 alleles were the only extensively replicated genetic factor but more genetic risk factors have now been identified that predispose to RA. Interestingly several of the observed genetic variants conferred risk to anticitrulline-peptide antibody ACPA -positive RA and two variants may be restricted to ACPA-negative RA pointing to the need for subclassification of RA. The current manuscript reviews recently identified genetic factors predisposing to ACPA-positive RA and ACPA-negative RA. Additionally although being scarcely explored genetic variants affecting the severity of disease course are discussed. Introduction Rheumatoid arthritis RA is a chronic potentially destructive arthritis classified by the presence of four out of the seven criteria developed by the American College of Rheumatology ACR in 1987. The criteria were formulated by experts who compared characteristics of patients with longstanding classical RA mean disease duration 8 years . These ACR criteria have been criticized during past years as they have a low discriminative ability in patients presenting with recentonset arthritis 1-4 . This is not surprising considering the components of the ACR criteria. One of the criteria is the presence of erosions on the radiographs of hands and .