Volume 8, Issue 3 pp. 153-175
Original Article
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Investigating the HLA component in rheumatoid arthritis: An additive (dominant) mode of inheritance is rejected, a recessive mode is preferred

Alan S. Rigby

Corresponding Author

Alan S. Rigby

Arthritis and Rheumatism Council Epidemiology Research Unit, University of Manchester Medical School, Oxford Road, Manchester, Great Britain

Department of Integrative Biology, University of California at Berkeley, Berkeley, California

ARC Epidemiology Research Unit, University of Manchester Medical School, Manchester M13 9PT, Great BritainSearch for more papers by this author
Alan J. Silman

Alan J. Silman

Arthritis and Rheumatism Council Epidemiology Research Unit, University of Manchester Medical School, Oxford Road, Manchester, Great Britain

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Lianne Voelm

Lianne Voelm

Department of Integrative Biology, University of California at Berkeley, Berkeley, California

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Julie C. Gregory

Julie C. Gregory

Arthritis and Rheumatism Council Epidemiology Research Unit, University of Manchester Medical School, Oxford Road, Manchester, Great Britain

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William E. R. Ollier

William E. R. Ollier

Arthritis and Rheumatism Council Epidemiology Research Unit, University of Manchester Medical School, Oxford Road, Manchester, Great Britain

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Muhammad A. Khan

Muhammad A. Khan

Case Western Reserve, University at Cleveland Metropolitan General Hospital, Cleveland, Ohio

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Gerald T. Nepom

Gerald T. Nepom

Virginia Mason Research Centre, 1000 Seneca Street, Seattle, Washington

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Glenys Thomson

Glenys Thomson

Department of Integrative Biology, University of California at Berkeley, Berkeley, California

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G. P. Vogler
First published: 1991
Citations: 77

Abstract

We examined the mode of inheritance of rheumatoid arthritis (RA) and estimated the genetic contribution of the HLA-linked locus to the development of RA using data from 111 multiplex families (54 London, 57 Cleveland), and 43 randomly ascertained patients (Seattle). HLA-DR4 was present in 78 multiplex probands (70%); a further 16 probands who were negative for DR4 were positive for DR1. Both DR4 and DR1 were significantly in excess when compared to control population frequencies (P < 0.001); an additional finding was an excess of DR7, although the numbers of probands with DR7 were small. Despite the well-established HLA association with RA, neither recessive nor additive (dominant) modes of inheritance, nor any intermediate models have been ruled out using affected sib-pair and antigen genotype frequency among patients (AGFAP) methods. However, in our study the AGFAP data for HLA-DR4 and DR1 were close to recessive expectations (P = ns) while an additive (dominant) mode of inheritance was rejected (P < 0.001). The same results were obtained by an independent method which considered HLA-DR transmission from affected parents to their affected children. The affected sib-pair haplotype sharing method showed deviation from random expectations but did not allow discrimination between recessive and additive (dominant) modes. The effect of the HLA-linked locus on familiarity accounted for only a 1.61-fold increased risk to sibs over the population prevalence, compared to an observed value of 3.90. This indicated that there could be at least one other non-HLA locus predisposing to RA with a weight that is slightly greater than that of HLA.

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