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Epidemiology

Interpreting studies of interactions between RA risk factors

Interactions between HLA and PTPN22 genotypes and smoking have been implicated in overall susceptibility to rheumatoid arthritis as well as the incidence of particular disease phenotypes in case–control and case-only studies. As recent epidemiological evidence shows, deciphering these interactions demands consideration of the analytical approach used.

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Figure 1: Study designs used to analyze risk factor interactions in RA.

References

  1. Costenbader, K. H., Feskanich, D., Mandl, L. A. & Karlson, E. W. Smoking intensity, duration, and cessation, and the risk of rheumatoid arthritis in women. Am. J. Med. 119, 503–511 (2006).

    Article  Google Scholar 

  2. Morgan, A. W. et al. Reevaluation of the interaction between HLA-DRB1 shared epitope alleles, PTPN22, and smoking in determining susceptibility to autoantibody-positive and autoantibody-negative rheumatoid arthritis in a large UK Caucasian population. Arthritis Rheum. 60, 2565–2576 (2009).

    Article  Google Scholar 

  3. Rothman, K. J. Epidemiology: an Introduction (Oxford University Press, New York, 2002).

    Google Scholar 

  4. Padyukov, L., Silva, C., Stolt, P., Alfredsson, L. & Klareskog, L. A gene–environment interaction between smoking and shared epitope genes in HLA-DR provides a high risk of seropositive rheumatoid arthritis. Arthritis Rheum. 50, 3085–3092 (2004).

    Article  CAS  Google Scholar 

  5. Klareskog, L. et al. A new model for an etiology of rheumatoid arthritis: smoking may trigger HLA-DR (shared epitope)-restricted immune reactions to autoantigens modified by citrullination. Arthritis Rheum. 54, 38–46 (2006).

    Article  CAS  Google Scholar 

  6. Hill, J. A. et al. Cutting edge: the conversion of arginine to citrulline allows for a high-affinity peptide interaction with the rheumatoid arthritis-associated HLA-DRB1*0401 MHC class II molecule. J. Immunol. 171, 538–541 (2003).

    Article  CAS  Google Scholar 

  7. Karlson, E. W. et al. Gene–environment interaction between HLA-DRB1 shared epitope and heavy cigarette smoking in predicting incident rheumatoid arthritis. Ann. Rheum. Dis. 69, 54–60 (2010).

    Article  CAS  Google Scholar 

  8. Linn-Rasker, S. P. et al. Smoking is a risk factor for anti-CCP antibodies only in rheumatoid arthritis patients who carry HLA-DRB1 shared epitope alleles. Ann. Rheum. Dis. 65, 366–371 (2006).

    Article  CAS  Google Scholar 

  9. Lee, H. S. et al. Interaction between smoking, the shared epitope, and anti-cyclic citrullinated peptide: a mixed picture in three large North American rheumatoid arthritis cohorts. Arthritis Rheum. 56, 1745–1753 (2007).

    Article  CAS  Google Scholar 

  10. Kallberg, H. et al. Gene–gene and gene–environment interactions involving HLA-DRB1, PTPN22, and smoking in two subsets of rheumatoid arthritis. Am. J. Hum. Genet. 80, 867–875 (2007).

    Article  Google Scholar 

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Correspondence to Elizabeth W. Karlson.

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Karlson, E., Costenbader, K. Interpreting studies of interactions between RA risk factors. Nat Rev Rheumatol 6, 72–73 (2010). https://doi.org/10.1038/nrrheum.2009.276

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