A new look at the shared epitope hypothesis.

The striking correlation observed between T cell recognition and the sharing of the DR-beta-1 gene sequences (position 67-74) among patients with rheumatoid arthritis studied suggests that the third hypervariable region might be an important contribution to one restriction site for the putative causative agent(s) in rheumatoid arthritis. The fact that this sequence was found in DR1, DR4,Dw14, and DR4,Dw15 beta-1 genes lends support to the hypothesis that, in some cases, human leukocyte antigen and disease association may involve the association of discrete disease-related epitopes rather than entire human leukocyte antigen genes and that these epitopes are immunologically relevant in terms of T cell recognition. The association of these polymorphisms with susceptibility to rheumatoid arthritis would then support the hypothesis that binding and presentation of "arthritogenic peptides" by major histocompatibility complex class II molecules is one of the pathogenic events in developing rheumatoid arthritis.