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Polymyalgia rheumatica and giant cell arteritis: A bidirectional Mendelian randomization study
1Yanbian University Hospital, Yanji, China.
Abstract:
Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) as 2 types of autoimmune diseases are frequently concomitant, and Mendelian randomization (MR) was applied in this study to assess the causal relationship between them. In this study, single-nucleotide polymorphism (SNP) was used as the instrumental variable for Mendelian analysis, and the SNP data of GCA and PMR were obtained from the FinnGen Biobank databases. SNPs are significantly correlated with GCA and PMR and were screened based on preset thresholds. Inverse variance weighted analysis was used as the main analysis, supplemented with MR-Egger and weighted median. The evidence of the impact of GCA on PMR risk was found in inverse variance weighted results (odds ratio, 1.22 [95% confidence interval, 1.11-1.34]; P < .01), and the evidence of the impact of PMR on GCA risk has also been found (odds ratio, 1.58 [95% confidence interval, 1.28-1.96]; P < .01). Finally, the stability and reliability of the results were tested using the retention method, heterogeneity test, and horizontal gene pleiotropy test. MR analysis indicates that GCA increases the risk of PMR and PMR is an important risk factor for GCA, with a causal relationship. The potential value of reasonable management of PMR in patients with GCA has received high attention. In addition, novel GCA therapeutics may be indicated for PMR, and it is a potential for further investigation.
Insights
Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) have a causal relationship. GCA increases PMR risk, and PMR is a risk factor for GCA, suggesting shared pathways and therapeutic potential.
Area of Science:
- Rheumatology
- Genetics
- Epidemiology
Background:
- Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) are common autoimmune diseases that often occur together.
- Understanding the causal relationship between PMR and GCA is crucial for effective patient management and therapeutic development.
Purpose of the Study:
- To investigate the causal relationship between polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) using Mendelian randomization.
- To determine if GCA influences the risk of developing PMR, and vice versa.
Main Methods:
- Mendelian randomization (MR) analysis utilizing single-nucleotide polymorphisms (SNPs) as instrumental variables.
- SNP data for GCA and PMR sourced from the FinnGen Biobank.
- Inverse variance weighted analysis, supplemented by MR-Egger and weighted median methods for robustness.
Main Results:
- Significant evidence indicates that GCA increases the risk of PMR (OR, 1.22; P < .01).
- Conversely, PMR was found to be an important risk factor for GCA (OR, 1.58; P < .01).
- Sensitivity analyses confirmed the stability and reliability of the findings.
Conclusions:
- A bidirectional causal relationship exists between GCA and PMR.
- Managing PMR in GCA patients may be beneficial, and GCA therapeutics could potentially be explored for PMR treatment.
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