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Rheumatology Advance Access originally published online on January 16, 2009
Rheumatology 2009 48(4):342-346; doi:10.1093/rheumatology/ken473
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© The Author 2009. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

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Genetics of bone loss in rheumatoid arthritis—role of vitamin D receptor polymorphisms

P. Ranganathan1

1Department of Medicine, Division of Rheumatology, Washington University School of Medicine, St Louis, MO, USA.

Correspondence to: P. Ranganathan, Department of Medicine, Division of Rheumatology, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8045, St Louis, MO 63110, USA. E-mail: prangana{at}im.wustl.edu


  Abstract

RA is a systemic inflammatory arthritis that leads to local and systemic bone loss. Osteoporosis or the systemic bone loss associated with RA increases the risk for fragility fractures, which can affect quality of life dramatically in RA patients. Although traditional and RA-related risk factors have been defined and studied for osteoporosis associated with RA, genetic factors such as polymorphic variants in the traditional candidate genes for osteoporosis, such as the vitamin D receptor (VDR), type 1 collagen A1 (COLIA1) and oestrogen receptor-{alpha} (ESR1), have not been well elucidated in RA patients. This review summarizes the currently available literature on the association of VDR polymorphisms with local and systemic bone loss in RA. It also discusses potential targets for genetic research in this area, such as polymorphisms in genes, such as IL-6 (IL6) and TNF receptor type 2 (TNFRSF1B), which control the inflammatory response in RA and may influence bone loss in RA. Defining such genetic factors, in addition to traditional and RA-related risk factors for osteoporosis in RA, may facilitate early identification of patients at high risk for fractures who can then be targeted for treatment.

KEY WORDS: Bone loss, Rheumatoid arthritis, Vitamin D receptor, Polymorphism

Submitted 22 September 2008; revised version accepted 21 November 2008.
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