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ID PMID Title PublicationDate abstract
21344040 Sleep quality and functional disability in patients with rheumatoid arthritis. 2011 Feb 15 STUDY OBJECTIVES: Disturbed sleep is a common complaint in patients with rheumatoid arthritis (RA). The majority of the research investigating relationships between sleep and patient-reported outcomes in RA has focused on pain and depression. Poor sleep may also affect disability, though this association has not been explored in RA. The present study represents a cross-sectional examination of the relationship between sleep quality and functional disability in 162 patients with RA. Depression, pain severity, and fatigue were examined as separate mediators of the relationship between sleep quality and disability. METHODS: The sample had an average age of 58.47 years, and 76% were female. Participants completed the following questionnaires as part of a medication adherence intervention study: Pittsburgh Sleep Quality Index, Beck Depression Inventory-II, Medical Outcomes Study Short Form-36, and the Health Assessment Questionnaire. RESULTS: Poor sleep quality was significantly correlated with higher levels of depressive symptoms, greater pain severity, increased fatigue, and greater functional disability. Hierarchical regression analyses showed that sleep quality was not associated with functional disability when depression, pain severity, and fatigue were entered into the model. Separate mediation analyses of depression, pain severity, and fatigue revealed that pain severity and fatigue were mediators of the relationship between sleep quality and disability. CONCLUSIONS: Sleep quality has an indirect effect on functional disability through its relationship with pain severity and fatigue. Future research should investigate whether improvements in sleep can reduce disability in patients with RA.
22002014 Look beyond the disease activity score of 28 joints (DAS28): tender points influence the D 2012 Jan OBJECTIVE: To explore the influence of tender points (TP) on the Disease Activity Score assessing 28 joints (DAS28) in patients with rheumatoid arthritis (RA). METHODS: In 200 consecutive patients with RA from the outpatient clinic, DAS28 and its components, tender and swollen joint counts (TJC, SJC, respectively), visual analog scale (VAS) for patient's general health (GH), and erythrocyte sedimentation rate (ESR), along with a tender point count (TPC) were assessed. Patients were categorized according to 4 TPC classes: zero, 1-5, 6-10, and ≥ 11 TP. The influence of TPC classes on DAS28 and its individual components was determined with Kruskal-Wallis tests and correlations between TP and DAS28 and its components were calculated. RESULTS: In 196 eligible patients, 70% were female, mean age was 59 years, and median disease duration was 3.9 years; median DAS28 was 3.1; and 49% had active disease, defined as DAS28 > 3.2. In 15% of patients, the TPC was ≥ 11, in 12% 6-10, in 30% 1-5, and in 43% zero. TPC significantly influenced the DAS28 and its less objective components TJC and VAS-GH (i.e., based on patient's report), but not the more objective DAS28 components SJC and ESR (i.e., observer- and laboratory-based). CONCLUSION: DAS28 is influenced by tender points, even in the non-fibromyalgia range, falsely suggesting higher disease activity and decreasing the sensitivity of the DAS28 criterion of low disease activity or remission. When applying DAS28-guided "tight control" or "treat-to-target" treatment strategies in RA, evaluation of not only the DAS28, but also its individual components along with a full joint and physical evaluation including assessment of TP is required to reliably estimate the individual's disease activity, which guides therapeutic decisions.
22012969 Sustained inhibition of progressive joint damage with rituximab plus methotrexate in early 2012 Mar BACKGROUND: In the IMAGEstudy, rituximab plus methotrexate (MTX) inhibited joint damage and improved clinical outcomes at 1 year in MTX-naïve patients with early active rheumatoid arthritis. OBJECTIVE: The aim of this study was to assess joint damage progression and clinical outcomes over 2 years. METHODS: Patients (n=755) were randomised to receive rituximab 2×500 mg+MTX, 2×1000 mg+MTX or placebo+MTX. The placebo-controlled period continued to week 104. Two-year end points were defined as secondary or exploratory and included change in total Genant-modified Sharp score (mTSS), total erosion score and joint space narrowing score from baseline to week 104. Clinical efficacy and physical function end points were also assessed. RESULTS: At 2 years, rituximab 2×1000 mg+MTX maintained inhibition of progressive joint damage versus MTX alone (mTSS change 0.41 vs 1.95; p<0.0001 (79% inhibition)), and a higher proportion of patients receiving rituximab 2×1000 mg+MTX had no radiographic progression over 2 years compared with those receiving MTX alone (57% vs 37%; p<0.0001). Contrary to 1-year results, exploratory analysis of rituximab 2×500 mg+MTX at 2 years showed that progressive joint damage was slowed by ∼61% versus placebo+MTX (mTSS, exploratory p=0.0041). Improvements in clinical signs and symptoms and physical function seen after 1 year in rituximab-treated patients versus those receiving placebo were maintained at year 2. Safety profiles were similar between groups. CONCLUSIONS: Treatment with rituximab 2×1000 mg+MTX was associated with sustained improvements in radiographic, clinical and functional outcomes over 2 years. Clinical trials.gov identifier NCT00299104.
22076918 Lectin-like oxidized low-density lipoprotein receptor 1 signal is a potent biomarker and t 2012 Apr OBJECTIVE: To determine whether lectin-like oxidized low-density lipoprotein (ox-LDL) receptor 1 (LOX-1) and the soluble form of LOX-1 (sLOX-1) are novel target molecules for the diagnosis and treatment of rheumatoid arthritis (RA). METHODS: Expression of ox-LDL and LOX-1 proteins in human RA synovium was evaluated by immunohistochemistry. Human RA fibroblast-like synoviocytes (FLS) were assessed for ox-LDL-induced expression of LOX-1 and ox-LDL-induced production of matrix metalloproteinase 1 (MMP-1) and MMP-3. Levels of sLOX-1 in the plasma and synovial fluid of patients with RA, compared with patients with osteoarthritis (OA), were determined by a specific chemiluminescence enzyme-linked immunoassay. In animal experiments, ox-LDL was injected into the knee joints of mice, with or without an anti-LOX-1 neutralizing antibody or sLOX-1, and the severity of arthritis was analyzed by histology and immunohistochemistry. RESULTS: Oxidized LDL and LOX-1 proteins were detected in the RA synovial tissue. Levels of MMP-1 and MMP-3 were enhanced by stimulation of RA FLS with ox-LDL, and the production of both MMPs was inhibited by blockade of the ox-LDL-LOX-1 interaction with the anti-LOX-1 neutralizing antibody or sLOX-1. Levels of sLOX-1 in the plasma and synovial fluid of RA patients were significantly higher than those in OA patients and healthy controls and were positively correlated with inflammation markers and the extent of RA disease activity. In the knees of mice, blockade of the ox-LDL-LOX-1 interaction suppressed arthritic changes and reduced the expression of MMP-3 induced by ox-LDL. CONCLUSION: These findings strongly indicate that sLOX-1 is a novel biomarker that may be useful for the diagnosis of RA and for the evaluation of disease activity in RA. Furthermore, the results suggest that LOX-1 may be a potent therapeutic target for RA.
22302385 Evaluation of cardiovascular risk in patients with rheumatoid arthritis: do cardiovascular 2012 Jun OBJECTIVE: To determine whether adding C-reactive protein, anti-cyclic citrullinated peptide antibodies, rheumatoid factor, N-terminal pro-brain natriuretic peptide (NT-proBNP), oxidized low-density lipoprotein (ox-LDL), or anti-apolipoprotein A-I (anti-Apo A-I) IgG to the Framingham 10-year cardiovascular (CV) risk score (FRS) could improve its CV prognostic accuracy in rheumatoid arthritis (RA). METHODS: We performed an ancillary study derived from a prospective single-center cohort consisting of 118 RA patients without CV disease at baseline. The FRS and the various biomarkers were assessed at enrollment and their prognostic accuracy was determined using receiver operating characteristic (ROC) curve analysis. The incremental predictive ability of biomarkers was assessed using the integrated discrimination improvement (IDI) statistics. RESULTS: During a median followup period of 9 years, the incidence of CV events was 16%. Both the FRS and 3 of the biomarkers (NT-proBNP, ox-LDL, and anti-Apo A-I) were significant predictors of subsequent CV events (area under the ROC curve [AUC] between 0.68 and 0.73). Anti-Apo A-I was the only biomarker to significantly improve the prognostic ability of the FRS, with AUCs increasing from 0.72 to 0.81 and the IDI improving by 175% (P < 0.001). CONCLUSION: Among the biomarkers tested, only anti-Apo A-I significantly improved the FRS predictive ability.
22874260 Estimating rheumatoid arthritis activity with infrared image analysis. 2012 This work describes the development of a new diagnostic tool to assess the severity of rheumatoid arthritis (RA) using infrared image collection and analysis. Early work showed that the temperature distribution of joints of hands and knees of patients with RA was statistically significantly different from that of normal subjects. Current work identified ankles as also significant for an assessment of RA. Moreover, the patients were classified in three levels of RA severity (High, Medium, and Low) using a C5.0 decision tree classifier with excellent results: Sensitivity (true positive cases) of 96 % and a specificity (true negative cases) of 92%. Future work will automate the image analysis and test clinically by comparing to MR as ground truth.
22089073 [How to effectively use methotrexate in rheumatoid arthritis?]. 2012 Jan Methotrexate (MTX) is the first choice disease modifying anti-rheumatic drugs for rheumatoid arthritis. In spite of its generalized use by rheumatologists worldwide, there is a general lack of agreement regarding the route of administration, the start-up dose and the way to increase the same. In this article we propose a simplified outline for the use of the drug that should be individualized, based on it's pharmacological aspects, guidelines and recommendations published in high impact factor journals during the past few years. Adverse reactions and side effects, as well as their follow up are also reviewed.
21852170 Rheumatoid arthritis is associated with less optimal hip structural geometry. 2012 Jan The overall goal of this study was to assess the longitudinal changes in bone strength in women reporting rheumatoid arthritis (RA; n=78) compared with nonarthritic control participants (n=4779) of the Women's Health Initiative bone mineral density (WHI-BMD) subcohort. Hip structural analysis program was applied to archived dual-energy X-ray absorptiometry scans (baseline, years 3, 6, and 9) to estimate bone mineral density (BMD) and hip structural geometry parameters in 3 femoral regions: narrow neck (NN), intertrochanteric (IT), and shaft (S). The association between RA and hip structural geometry was tested using linear regression and random coefficient models. Compared with the nonarthritic control, the RA group had a lower BMD (p=0.061) and significantly lower outer diameter (p=0.017), cross-sectional area (p=0.004), and section modulus (p=0.035) at the NN region in the longitudinal models. No significant associations were seen at the IT regions or S regions, and the association was not modified by age, ethnicity, glucocorticoid use, or time. Within the WHI-BMD, women with RA group had reduced BMD and structural geometry at baseline, and this reduction was seen at a fixed rate throughout the 9 yr of study.
21843325 Cardiovascular events in early RA are a result of inflammatory burden and traditional risk 2011 Aug 15 INTRODUCTION: Co-morbidity and mortality due to cardiovascular disease (CVD) are increased in patients with rheumatoid arthritis (RA). Most published studies in this field are retrospective or cross sectional. We investigated the presence of traditional and disease related risk factors for CVD at the onset of RA and during the first five years following diagnosis. We also evaluated their potential for predicting a new cardiovascular event (CVE) during the five-year follow-up period and the modulatory effect of pharmacological treatment. METHODS: All patients from the four northern-most counties of Sweden with early RA are, since December 1995, consecutively recruited at diagnosis (T0) into a large survey on the progress of the disease. Information regarding cardiovascular co-morbidity and related predictors was collected from clinical records and supplemented with questionnaires. By April 2008, 700 patients had been included of whom 442 patients had reached the five-year follow-up (T5). RESULTS: Among the 442 patients who reached T5 during the follow-up period, treatment for hypertension increased from 24.5 to 37.4% (P < 0.001)), diagnosis of diabetes mellitus (DM) from 7.1 to 9.5% (P < 0.01) whilst smoking decreased from 29.8 to 22.4% (P < 0.001) and the BMI from 26.3 to 25.8 (P < 0.05), respectively. By T5, 48 patients had suffered a new CVE of which 12 were fatal. A total of 23 patients died during the follow-up period. Age at disease onset, male sex, a previous CVE, DM, treatment for hypertension, triglyceride level, cumulative disease activity (area under the curve (AUC) disease activity score (DAS28)), extra-articular disease, corticosteroid use, shorter duration of treatment with disease modifying anti-rheumatic drugs (DMARDs) and use of COX-2 inhibitors increased the hazard rate for a new CVE. A raised erythrocyte sedimentation rate (ESR) at inclusion and AUC DAS28 at six months increased the hazard rate of CVE independently whilst DMARD treatment was protective in multiple Cox extended models adjusted for sex and CV risk factors. The risk of a CVE due to inflammation was potentiated by traditional CV risk factors. CONCLUSIONS: The occurrence of new CV events in very early RA was explained by traditional CV risk factors and was potentiated by high disease activity. Treatment with DMARDs decreased the risk. The results may have implications for cardio-protective strategies in RA.
22413822 Rheumatology meets hepatology in 2012: a clinician's guideline for TNF inhibitors in hepat 2012 Apr Effective and less toxic biologics have revolutionized rheumatology as well as hepatology over the last decennia resulting in higher therapeutic goals. Traditional disease modifying anti-rheumatic drugs (tDMARDs) failing to achieve a quiescent chronic rheumatoid arthritis (RA) or spondylarthropathic arthritis (SA) inflammatory disease, nowadays are to be switched into a more potent strategy with ultimately a combination of tDMARD plus TNF inhibitors (TNFi) early in disease. Patients with previous microbiological infections however present a challenge for a modern rheumatologist aiming at complete remission, particularly in carriers of viral infections. Hepatologists nowadays, can treat chronic hepatitis B and C virus infections effectively with potent antivirals. In the current issue an overview is given regarding patients in whom TNFi may be indicated, but also have been infected with viral hepatitis.
21506093 Association of endogenous anti-interferon-α autoantibodies with decreased interferon-path 2011 Aug OBJECTIVE: Numerous observations implicate interferon-α (IFNα) in the pathophysiology of systemic lupus erythematosus (SLE); however, the potential impact of endogenous anti-IFNα autoantibodies (AIAAs) on IFN-pathway and disease activity is unclear. The aim of this study was to characterize IFN-pathway activity and the serologic and clinical profiles of AIAA-positive patients with SLE. METHODS: Sera obtained from patients with SLE (n = 49), patients with rheumatoid arthritis (n = 25), and healthy control subjects (n = 25) were examined for the presence of AIAAs, using a biosensor immunoassay. Serum type I IFN bioactivity and the ability of AIAA-positive sera to neutralize IFNα activity were determined using U937 cells. Levels of IFN-regulated gene expression in peripheral blood were determined by microarray, and serum levels of BAFF, IFN-inducible chemokines, and other autoantibodies were measured using immunoassays. RESULTS: AIAAs were detected in 27% of the serum samples from patients with SLE, using a biosensor immunoassay. Unsupervised hierarchical clustering analysis identified 2 subgroups of patients, IFN(low) and IFN(high) , that differed in the levels of serum type I IFN bioactivity, IFN-regulated gene expression, BAFF, anti-ribosomal P, and anti-chromatin autoantibodies, and in AIAA status. The majority of AIAA-positive patients had significantly lower levels of serum type I IFN bioactivity, reduced downstream IFN-pathway activity, and lower disease activity compared with the IFN(high) patients. AIAA-positive sera were able to effectively neutralize type I IFN activity in vitro. CONCLUSION: Patients with SLE commonly harbor AIAAs. AIAA-positive patients have lower levels of serum type I IFN bioactivity and evidence for reduced downstream IFN-pathway and disease activity. AIAAs may influence the clinical course in SLE by blunting the effects produced by IFNα.
22338476 [Association of TNF-alpha polymorphism (-308 A/G) with high activity of rheumatoid arthrit 2011 Nov INTRODUCTION: Genetic markers are significant predictive factors in the assessment of therapeutic response of rheumatoid arthritis (RA) to biological medication. OBJECTIVE: The aim of the study was to determinate the association of TNF-alpha -308 G/A polymorphism with a high RA activity and its predictive value in therapeutic response after 12 months of treatment with Etanercept. METHODS: The study enrolled 132 patients with RA treated with Methotrexate (MTX) and 58 control subjects. The -308 TNF polymorphism was examined using the polymerase chain reaction - restriction fragment length polymorphism (PCR-RFLP). The patients were divided into two groups: group A with A/A and A/G genotype and group G with G/G genotype. After 12 months, beside MTX, Etanercept was introduced in 36 patients. We compared clinical activity among the groups at the beginning and after one year of therapy by using DAS28 SE (Disease activity score with sedimentation). RESULTS: There was no significant difference found in the distribution of G and A allele in the RA group compared to the control group. A significantly higher disease activity was noticed in A compared to the G group (DAS28 SE: 6.31 to 5.81; p < 0.05). The patients with A allele kept the majority of the disease activity even after a year of study (DAS28 SE: 5.25 to 3.89). After a year of MTX and Etanercept therapy, a significantly larger proportion of patients in the G group displayed a good clinical response to treatment compared to the A group (81.5% to 25%; p < 0.05). The average change of DAS28 SE in G group was 2.24, while in the A group DAS 28 reduction was significantly lower (1.17; p = 0.005). CONCLUSION: There was no significant difference in the frequency of A in the patients with RA compared to healthy subjects. The presence of A allele is associated with more serious clinical presentation of the disease and lower therapeutic response to Etanercept.
21557111 Biologics in rheumatoid arthritis--recommendations for Swiss practice. 2011 The new paradigm of therapy in rheumatoid arthritis is to aim toward early and complete remission, using a larger use of conventional DMARDs and biologic agents. The present recommendations were established through a consensus to help practitioners in their daily use of those agents, to reflect the current "best practice" in Switzerland.
22626259 Discovery of novel PI3-kinase δ specific inhibitors for the treatment of rheumatoid arthr 2012 Jun 28 PI3Kδ is a lipid kinase and a member of a larger family of enzymes, PI3K class IA(α, β, δ) and IB (γ), which catalyze the phosphorylation of PIP2 to PIP3. PI3Kδ is mainly expressed in leukocytes, where it plays a critical, nonredundant role in B cell receptor mediated signaling and provides an attractive opportunity to treat diseases where B cell activity is essential, e.g., rheumatoid arthritis. We report the discovery of novel, potent, and selective PI3Kδ inhibitors and describe a structural hypothesis for isoform (α, β, γ) selectivity gained from interactions in the affinity pocket. The critical component of our initial pharmacophore for isoform selectivity was strongly associated with CYP3A4 time-dependent inhibition (TDI). We describe a variety of strategies and methods for monitoring and attenuating TDI. Ultimately, a structure-based design approach was employed to identify a suitable structural replacement for further optimization.
20024554 Effects of the anti-interleukin-6 receptor antibody, tocilizumab, on serum lipid levels in 2011 Apr We investigated the effects of anti-IL-6 receptor antibody, tocilizumab (TCZ), on lipid metabolism. Nineteen patients with rheumatoid arthritis (RA), entered in clinical case-control study of SAMURAI trial at Sasebo Chuo Hospital, were examined. Nine patients received TCZ monotherapy at 8 mg/kg intravenously every 4 weeks (TCZ group) and 10 patients received conventional DMARDs (control group). Serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), apolipoprotein (Apo) A-1, Apo A-2 and Apo B as well as disease activity score (DAS), C-reactive protein and serum amyloid A protein were examined at baseline and after 3 months of the treatment. IL-6 inversely was correlated with LDL, Apo A-1 and Apo A-2, and also tended to correlate with Apo B. In TCZ group, serum levels of TC, HDL, LDL, Apo A-1 and Apo A-2 were significantly increased after 3 months treatment with TCZ. There was no significant change in Apo B, the atherogenic index, and TC/HDL by the TCZ treatment. Changes in the DAS28-ESR negatively correlated with those in TC. In one patient, whose serum level of TCZ was not detected after 3 months of the treatment, the absence of the increment in serum levels of Apo A-1 and A-2 in the patient was remarkable. All of the markers did not change during 3 months in control group. These data may raise an important issue to evaluate the impact of these alternations in lipid metabolism for longer periods in RA patients treated with TCZ.
22945870 B cells and CD22 are dispensable for the immediate antiinflammatory activity of intravenou 2012 Dec Intravenous immunoglobulins (IVIgs) efficiently suppress a variety of autoimmune diseases. Over the past few years several potential mechanisms underlying this antiinflammatory activity have become apparent. Among these, terminal sialic acid residues in the sugar moiety of the immunoglobulin G constant fragment have been shown to be critical for the antiinflammatory activity of IVIgs in models of rheumatoid arthritis and immunothrombocytopenia (ITP). More recently, B cells and the sialic acid-binding protein CD22 were suggested to be involved in this IVIg-dependent immunomodulatory pathway. To study whether B cells are directly involved in IVIg-mediated suppression of acute autoimmune diseases, we tested the activity of IVIgs in mice deficient in B cells or CD22. We show that neither B cells nor CD22 are critical for the immediate antiinflammatory activity of IVIgs in mouse models of rheumatoid arthritis and ITP.
22040555 Changes in serum levels of soluble osteoclast-associated receptor in human rheumatoid arth 2011 Oct BACKGROUND: Osteoclast-associated receptor (OSCAR) is a member of the newly identified leukocyte receptor complex, and has recently been described as a key molecule in osteoclastogenesis. In this study, we measured the levels of soluble osteoclast-associated receptor (sOSCAR) in the serum of rheumatoid arthritis (RA) patients and healthy controls to examine whether sOSCAR may play a role in the process of inflammatory arthritis. METHODS: Enzyme-linked immunosorbent assay (ELISA) was used to measure the levels of sOSCAR in the serum of 40 healthy controls and 40 RA patients. RESULTS: The serum levels of sOSCAR were significantly lower in RA patients than in healthy controls, and were inversely associated with inflammatory activity. CONCLUSION: sOSCAR is decreased in patients with RA and reduced levels of the protein are associated with increased inflammatory response.
22083616 Anti-cyclic citrullinated peptide antibodies and rheumatoid factor sera titers in leprosy 2012 Nov Leprosy offers a broad spectrum of altered immunological sceneries, ranging from strong cell-mediated immune responses seen in tuberculoid leprosy (TT), through borderline leprosy (BB), to the virtual absence of T cell responses characteristic in lepromatous leprosy (LL). The exact mechanism of autoantibodies production remains unknown in leprosy and other chronic inflammatory diseases and also the contribution of these antibodies to the pathogenesis of the disease. The aim of this study is to evaluate the frequency and profiles of serum anti-cyclic citrullinated peptide antibodies (a-CCP), rheumatoid factor (RF) and its relationship with leprosy spectrum. Serum samples from 67 leprosy patients (54 LL, 5 TT and 8 BB) and 46 clinically healthy subjects (CHS) from the same endemic region were investigated. The clinical chart and questionnaire were used to obtain clinical information. Anti-cyclic citrullinated peptide antibodies (a-CCP) were measured by enzyme-linked immunosorbent assay, whereas the rheumatoid factor (RF) levels were measured by nephelometric method. The mean age of patients was 51.5 ± 13 years. Sera levels of a-CCP where higher in leprosy patients than in CHS (5.9 ± 11.6 vs. 0.3 ± 0.29) (P < 0.0001); the same pattern was found for RF sera titers without reaching statistical significance (16.8 ± 22.5 vs. 9.9 ± 3) (P = NS). We did not find a correlation between a-CCP and RF Rho =0.02786 (IC 95%) P = 0.8229. However, LL patients had higher a-CCP and RF levels than TT patients. Although an absence in correlation was observed, the serum levels of a-CCP antibodies and RF appeared to be useful in distinguishing LL from TT patients with a limited significance in detecting reactional leprosy patients.
22046784 [Descriptive assessments of a series of rheumatoid arthritis patients admitted to rehabili 2011 Jul AIM: To assess some demographic features in a series of 741 rheumatoid arthritis patients admitted to the Clinic Hospital of Rehabilitation at Iasi in different stages of disease in order to select the most adequate rehabilitation teratment. MATERIAL AND METHODS: Data were collected from patients' records, hospital statistical reports, and then processed and interpreted using EPI/INFO and MS Excel. RESULTS: Sex distribution revealed that the disease was more common in females (male/female ratio 0.2). The prevalence was higher after the age of 40, from 15.4% to 33.8% between 51 and 60, and 40.2% after 61. The most important comorbidities were related to osteoporosis (48.9%), ischemic cardiopathy and essential arterial hypertension (40.1%), impaired glucose tolerance and diabetes mellitus (36.9%), viral hepatitis B and C (24.02% of all cases). CONCLUSIONS: In selecting the most adequate rehabilitation treatment (drug therapy, kinetotherapy, and physical therapy) patient's age, and his various associated diseases have to be considered.
21600898 Insight from genome-wide association studies in rheumatoid arthritis and multiple sclerosi 2011 Dec 1 Autoimmune diseases are caused by multiple genes and environmental effects. In addition, genetic contributions and the number of associated genes differ among different diseases and ethnic populations. Genome-wide association studies (GWAS) on rheumatoid arthritis (RA) and multiple sclerosis (MS) show that these diseases share many genetic factors. Recently, in addition to the major histocompatibility complex (MHC) gene, other genetic loci have been found to be associated with the risk for autoimmune diseases. This review focuses on the search for genetic variants that influence the susceptibility to RA and MS as typical autoimmune diseases and discusses the future of GWAS.