Combined influence of genetic and environmental factors in age of rheumatoid arthritis onset

Rheumatol Int. 2012 Oct;32(10):3097-102. doi: 10.1007/s00296-011-2090-9. Epub 2011 Sep 16.

Abstract

To study the combined effect of both genetic and environmental factors in the age of rheumatoid arthritis onset. Patients (n = 507). Shared epitope characterization was performed using Lifecodes HLA-SSO. Genotyping of protein tyrosine phosphatase non-receptor 22 (PTPN22) rs2476601 and signal transducers and activators of transcription 4 (STAT4) rs7574865 polymorphism was performed using fast real-time PCR System. Shared epitope, antibodies directed against cyclic citrulinated peptide (anti-CCP) antibodies and a higher level of education were associated with a younger age at disease onset (P = 0.033, P = 0.004 and P < 0.0001, respectively). Neither carriers of the minor allele of PTPN22 rs2476601 nor STAT4 rs7574 polymorphisms showed a significant association with a younger age at disease onset (P = 0.355, P = 0.065, respectively). We found an additive effect of the three genetic markers in the age at onset: subjects with three markers were associated with a disease onset 9.56, 8.61, and 6.41 years before than those with none, one, or two genetic markers (P = 0.004, P = 0.006 and P = 0.043, respectively). We also described the additive effect of shared epitope, anti-CCP antibodies, educational level, PTPN22, and STAT4 polymorphisms in age at onset. Patients with two, three, four, or five variables were associated with a significant younger age of disease onset (4.72 [0.05-9.38] years (P = 0.048), 9.56 [4.72-14.40] years (P < 0.0001), 12.74 [6.84-18.64] years (P < 0.0001), and 20.87 [10.40-37.17] years (P < 0.0001)). Risk factors for the development of rheumatoid arthritis are also associated, with an additive effect, with a younger age at disease onset.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age of Onset
  • Arthritis, Rheumatoid / epidemiology*
  • Arthritis, Rheumatoid / genetics
  • Arthritis, Rheumatoid / immunology
  • Autoantibodies / blood
  • Child
  • Educational Status
  • Environment*
  • Epitopes
  • Female
  • Genetic Predisposition to Disease
  • HLA-DRB1 Chains / genetics*
  • HLA-DRB1 Chains / immunology
  • Humans
  • Linear Models
  • Male
  • Peptides, Cyclic / immunology
  • Polymorphism, Genetic
  • Protein Tyrosine Phosphatase, Non-Receptor Type 22 / genetics*
  • Risk Assessment
  • Risk Factors
  • STAT4 Transcription Factor / genetics*
  • Spain / epidemiology

Substances

  • Autoantibodies
  • Epitopes
  • HLA-DRB1 Chains
  • Peptides, Cyclic
  • STAT4 Transcription Factor
  • STAT4 protein, human
  • cyclic citrullinated peptide
  • PTPN22 protein, human
  • Protein Tyrosine Phosphatase, Non-Receptor Type 22