N. Tanaka et al., A retrospective study using nail clippings of rheumatoid susceptible alleles of HLA-DRB1 as a prognostic factor in early rheumatoid arthritis, J RHEUMATOL, 26(4), 1999, pp. 767-772
Objective. To evaluate whether the number of susceptible factors influences
disease progression in Japanese patients diagnosed with early rheumatoid a
rthritis (RA).
Methods. Fifty-eight Japanese outpatients (46 female, 12 male; mean age 48.
9 yrs) with early RA of less than one year after onset were enrolled in the
study. The criteria for early RA (Japanese Ministry of Welfare) were used.
DNA was extracted from fingernail clippings and the gene frequencies of HL
A-DRB1 alleles were investigated. The degrees of progression of (1) clinica
l symptoms, (2) laboratory findings, (3) radiographic changes, and (4) magn
etic resonance imaging score were analyzed by a comparison of the above at
time of diagnosis and at final examination (an average of 14 months after t
he time of diagnosis).
Results, The frequencies of the susceptible factors (S: 0101, 0401, 0404, 0
405, 1001, and 1402) were 17, 3.4, 0.9, 29, 0, and 0%, respectively. The pr
ogression of inflammatory autoimmune activity, erosion incidence, and synov
ial proliferation severity in the S/S group was significantly more rapid th
an that in the other groups. Tn the disease activity at each time, thr diff
erence between the S/S group and the S/N group was significant, as was that
between the S/S group and the N/N group, but the difference between the S/
N group and the N/N group was not significant.
Conclusion, Haplotyping of HLA-DRB1 using the patient's nail clippings may
be useful as a prognostic marker for disease progression in early RA.