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      Five amino acids in three HLA proteins explain most of the association between MHC and seropositive rheumatoid arthritis

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          Abstract

          The genetic association of the major histocompatibility complex (MHC) to rheumatoid arthritis risk has commonly been attributed to HLA-DRB1 alleles. Yet controversy persists about the causal variants in HLA-DRB1 and the presence of independent effects elsewhere in the MHC. Using existing genome-wide SNP data in 5,018 seropositive cases and 14,974 controls, we imputed and tested classical alleles and amino acid polymorphisms for HLA-A, B, C, DPA1, DPB1, DQA1, DQB1, and DRB1 along with 3,117 SNPs across the MHC. Conditional and haplotype analyses reveal that three amino acid positions (11, 71 and 74) in HLA-DRβ1, and single amino acid polymorphisms in HLA-B (position 9) and HLA-DPβ1 (position 9), all located in the peptide-binding grooves, almost completely explain the MHC association to disease risk. This study illustrates how imputation of functional variation from large reference panels can help fine-map association signals in the MHC.

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          Most cited references21

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          The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis.

          The revised criteria for the classification of rheumatoid arthritis (RA) were formulated from a computerized analysis of 262 contemporary, consecutively studied patients with RA and 262 control subjects with rheumatic diseases other than RA (non-RA). The new criteria are as follows: 1) morning stiffness in and around joints lasting at least 1 hour before maximal improvement; 2) soft tissue swelling (arthritis) of 3 or more joint areas observed by a physician; 3) swelling (arthritis) of the proximal interphalangeal, metacarpophalangeal, or wrist joints; 4) symmetric swelling (arthritis); 5) rheumatoid nodules; 6) the presence of rheumatoid factor; and 7) radiographic erosions and/or periarticular osteopenia in hand and/or wrist joints. Criteria 1 through 4 must have been present for at least 6 weeks. Rheumatoid arthritis is defined by the presence of 4 or more criteria, and no further qualifications (classic, definite, or probable) or list of exclusions are required. In addition, a "classification tree" schema is presented which performs equally as well as the traditional (4 of 7) format. The new criteria demonstrated 91-94% sensitivity and 89% specificity for RA when compared with non-RA rheumatic disease control subjects.
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            A high-resolution HLA and SNP haplotype map for disease association studies in the extended human MHC.

            The proteins encoded by the classical HLA class I and class II genes in the major histocompatibility complex (MHC) are highly polymorphic and are essential in self versus non-self immune recognition. HLA variation is a crucial determinant of transplant rejection and susceptibility to a large number of infectious and autoimmune diseases. Yet identification of causal variants is problematic owing to linkage disequilibrium that extends across multiple HLA and non-HLA genes in the MHC. We therefore set out to characterize the linkage disequilibrium patterns between the highly polymorphic HLA genes and background variation by typing the classical HLA genes and >7,500 common SNPs and deletion-insertion polymorphisms across four population samples. The analysis provides informative tag SNPs that capture much of the common variation in the MHC region and that could be used in disease association studies, and it provides new insight into the evolutionary dynamics and ancestral origins of the HLA loci and their haplotypes.
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              The shared epitope hypothesis. An approach to understanding the molecular genetics of susceptibility to rheumatoid arthritis.

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                Author and article information

                Journal
                9216904
                2419
                Nat Genet
                Nat. Genet.
                Nature genetics
                1061-4036
                1546-1718
                15 December 2011
                29 January 2012
                01 September 2012
                : 44
                : 3
                : 291-296
                Affiliations
                [1 ]Division of Genetics, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, USA
                [2 ]Division of Rheumatology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, USA
                [3 ]Partners HealthCare Center for Personalized Genetic Medicine, Boston, MA, USA
                [4 ]Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
                [5 ]Robert S. Boas Center for Genomics and Human Genetics, Feinstein Institute for Medical Research, North Shore–Long Island Jewish Health System, Manhasset, NY USA
                [6 ]Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea
                [7 ]Harvard-MIT Division of Health Sciences and Technology, Boston, MA
                [8 ]Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
                [9 ]Rheumatology Unit, Department of Medicine, Karolinska Institutet at Karolinska University Hospital Solna, Stockholm, Sweden
                [10 ]Arthritis Research UK Epidemiology Unit, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
                [11 ]Department of Medicine, University of Toronto, Mount Sinai Hospital and University Health Network, Toronto, Ontario, Canada
                [12 ]Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
                [13 ]Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
                Author notes
                []To whom correspondence should be addressed: soumya@ 123456broadinstitute.org (S.R.); pdebakker@ 123456rics.bwh.harvard.edu (P.I.W.d.B.)
                Article
                NIHMS344269
                10.1038/ng.1076
                3288335
                22286218
                4e7acb91-84e6-4265-a0e9-ce1e765b34c2

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                History
                Funding
                Funded by: National Institute of Arthritis and Musculoskeletal and Skin Diseases : NIAMS
                Award ID: K08 AR055688-04 || AR
                Funded by: National Institute of Arthritis and Musculoskeletal and Skin Diseases : NIAMS
                Award ID: K08 AR055688-01A1S1 || AR
                Categories
                Article

                Genetics
                Genetics

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