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© 1993 British Society for Rheumatology


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UNUSUAL DQA-DR HAPLOTYPES IN RHEUMATOID VASCULITIS

M. C. HILLARBY, W. E. R. OLLIER*, M. DAVIS{ddagger}, J. DAVIDSON{ddagger}, P. A. SANDERS and D. M. GRENNAN

University of Manchesrer, Centre for Rheumatic Diseases, Hope Hospital Salford, M6 8HD
*ARC Epidemiology Research Unit Stopford Building, University of Manchester
{ddagger}Staffordshire Rheumarology Unit, Sroke on Trent
{ddagger}Regional Tissiie Typing Laboratory, St Mary's Hospital Manchester

Correspondence to: Correspondence to Dr D. Grennan, Reader in Rheumatology, University of Manchester

DQA and DQB variants and HLA haplotypes were defined in Caucasian subjects with rheumatoid arthritis (RA), in a rheumatoid subset characterized clinically by extra-articular features of major vasculitis, and in controls. DQ variants were defined using a panel of sequence specific oligonucleotide probes. In RA subjects without extra-articular features the frequency of DQB*0301 was significantly increased but this was secondary to the main association with DR4. In rheumatoid vasculitis by contrast, DQB*0302 rather than DQB*0301 was increased in frequency, in addition to an increase of C4A null alleles. Family studies showed that DR4 negative haplotypes had an increased frequency of unusual DR-DQA combinations as compared to other rheumatoid subsets. These findings are in keeping with the concept that genes within the MHC other than DR4 have a disease-modifying role in rheumatoid subsets. HLA haplotypes were defined in a family where the proband has RA and Felty's syndrome and an affected sister has rheumatoid vasculitis. These siblings share a DR4 bearing haplotype typing for DQB*0301, and the sister with rheumatoid vasculitis has a DR4 negative haplotype carrying a C4A null allele and an unusual DR-DQA combination.

KEY WORDS: MHC, Rheumatoid arthritis, HLA-DQA, HLA-DQB, HLA-DR


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