Negative association of the chemokine receptor CCR5 d32 polymorphism with systemic inflammatory response, extra-articular symptoms and joint erosion in rheumatoid arthritis
| Autor: | Manuela Rossol, Matthias Pierer, Gernot Keyßer, Christoph Baerwald, Harald Burkhardt, Ulf Wagner, Sybille Arnold |
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| Jazyk: | angličtina |
| Rok vydání: | 2009 |
| Předmět: |
Adult
Cartilage Articular Male medicine.medical_specialty Adolescent Receptors CCR5 Chemokine receptor CCR5 Receptor expression Immunology Rheumatoid nodule Arthritis Arthritis Rheumatoid Cohort Studies Young Adult Rheumatology Internal medicine medicine Humans Immunology and Allergy ddc:610 Aged Retrospective Studies Autoimmune disease Aged 80 and over Polymorphism Genetic biology business.industry Genetic Carrier Screening CCL18 Middle Aged medicine.disease Systemic Inflammatory Response Syndrome Rheumatoid arthritis Case-Control Studies biology.protein Female medicine.symptom business Gene Deletion Research Article |
| Zdroj: | Arthritis Research & Therapy |
| Popis: | Introduction Chemokines and their receptors control immune cell migration during infections as well as in autoimmune responses. A 32 bp deletion in the gene of the chemokine receptor CCR5 confers protection against HIV infection, but has also been reported to decrease susceptibility to rheumatoid arthritis (RA). The influence of this deletion variant on the clinical course of this autoimmune disease was investigated. Methods Genotyping for CCR5d32 was performed by PCR and subsequent electrophoretic fragment length determination. For the clinical analysis, the following extra-articular manifestations of RA were documented by the rheumatologist following the patient: presence of rheumatoid nodules, major organ vasculitis, pulmonary fibrosis, serositis or a Raynaud's syndrome. All documented CRP levels were analyzed retrospectively, and the last available hand and feet radiographs were analyzed with regards to the presence or absence of erosive disease. Results Analysis of the CCR5 polymorphism in 503 RA patients and in 459 age-matched healthy controls revealed a significantly decreased disease susceptibility for carriers of the CCR5d32 deletion (Odds ratio 0.67, P = 0.0437). Within the RA patient cohort, CCR5d32 was significantly less frequent in patients with extra-articular manifestations compared with those with limited, articular disease (13.2% versus 22.8%, P = 0.0374). In addition, the deletion was associated with significantly lower average CRP levels over time (median 8.85 vs. median 14.1, P = 0.0041) and had a protective effect against the development of erosive disease (OR = 0.40, P = 0.0047). Intriguingly, homozygosity for the RA associated DNASE2 -1066 G allele had an additive effect on the disease susceptibility conferred by the wt allele of CCR5 (OR = 2.24, P = 0.0051 for carrier of both RA associated alleles) Conclusions The presence of CCR5d32 significantly influenced disease susceptibility to and clinical course of RA in a German study population. The protective effect of this deletion, which has been described to lead to a decreased receptor expression in heterozygous patients, underlines the importance of chemokines in the pathogenesis of RA. |
| Databáze: | OpenAIRE |
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