OBJECTIVE: To test the hypothesis that the influence of the HLA-DRB1 shared epitope (SE) on the clinical manifestations of rheumatoid arthritis (RA) differs between men and women. METHODS: We assessed 777 consecutive RA patients for age at disease onset, articular manifestations, subcutaneous nodules, laboratory and radiographic findings, and treatment received. We typed HLA-DRB1 alleles by polymerase chain reaction-sequence-specific primer amplification and categorized the number of SE-containing alleles. We used regression models to adjust comparisons between the sexes for age and clustering by recruitment center, and included SE x sex interaction terms to look for heterogeneity between men and women in the effect of the SE. RESULTS: Among the 777 RA patients, 548 (71%) were women. Men and women differed significantly in the adjusted frequency of SE positivity (women 71.4% versus men 78.4%; P < or = 0.001). The SE was associated with a younger age at symptom onset and RA diagnosis among men, but not among women. The SE likewise had a significant adverse effect on joint tenderness, swelling, and deformity among men only. The SE was associated with a higher erythrocyte sedimentation rate in women and more frequent positivity for rheumatoid factor among both men and women. CONCLUSION: There is heterogeneity between men and women in the effect of the SE on RA susceptibility and clinical expression. Further research is needed to understand the mechanism of this heterogeneity.
OBJECTIVE: To test the hypothesis that the influence of the HLA-DRB1 shared epitope (SE) on the clinical manifestations of rheumatoid arthritis (RA) differs between men and women. METHODS: We assessed 777 consecutive RApatients for age at disease onset, articular manifestations, subcutaneous nodules, laboratory and radiographic findings, and treatment received. We typed HLA-DRB1 alleles by polymerase chain reaction-sequence-specific primer amplification and categorized the number of SE-containing alleles. We used regression models to adjust comparisons between the sexes for age and clustering by recruitment center, and included SE x sex interaction terms to look for heterogeneity between men and women in the effect of the SE. RESULTS: Among the 777 RApatients, 548 (71%) were women. Men and women differed significantly in the adjusted frequency of SE positivity (women 71.4% versus men 78.4%; P < or = 0.001). The SE was associated with a younger age at symptom onset and RA diagnosis among men, but not among women. The SE likewise had a significant adverse effect on joint tenderness, swelling, and deformity among men only. The SE was associated with a higher erythrocyte sedimentation rate in women and more frequent positivity for rheumatoid factor among both men and women. CONCLUSION: There is heterogeneity between men and women in the effect of the SE on RA susceptibility and clinical expression. Further research is needed to understand the mechanism of this heterogeneity.
Authors: Emily Molina; Inmaculada Del Rincon; Jose Felix Restrepo; Daniel F Battafarano; Agustin Escalante Journal: Arthritis Care Res (Hoboken) Date: 2015-07 Impact factor: 4.794
Authors: Giovanna Ibeth Cruz; Xiaorong Shao; Hong Quach; Kimberly A Ho; Kirsten Sterba; Janelle A Noble; Nikolaos A Patsopoulos; Michael P Busch; Darrell J Triulzi; Wendy Sw Wong; Benjamin D Solomon; John E Niederhuber; Lindsey A Criswell; Lisa F Barcellos Journal: Ann Rheum Dis Date: 2017-04-08 Impact factor: 19.103
Authors: Emily Molina; Inmaculada del Rincon; Jose Felix Restrepo; Daniel F Battafarano; Agustin Escalante Journal: BMC Musculoskelet Disord Date: 2015-10-05 Impact factor: 2.362
Authors: Sami B Kanaan; Onur E Onat; Nathalie Balandraud; Gabriel V Martin; J Lee Nelson; Doua F Azzouz; Isabelle Auger; Fanny Arnoux; Marielle Martin; Jean Roudier; Tayfun Ozcelik; Nathalie C Lambert Journal: PLoS One Date: 2016-06-29 Impact factor: 3.240
Authors: Rector Arya; Elizabeth Hare; Inmaculada Del Rincon; Christopher P Jenkinson; Ravindranath Duggirala; Laura Almasy; Agustin Escalante Journal: BMC Proc Date: 2009-12-15