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Immunogenetics of polymyalgia rheumatica

K F al-Jarallah1, W W Buchanan, A Sastry

  • 1Department of Medicine, McMaster University, Hamilton, Ontario, Canada.

Clinical and Experimental Rheumatology
|September 1, 1993
PubMed
Summary

Polymyalgia rheumatica (PMR) patients show a significantly higher prevalence of HLA-DR4 and its subtype Dw13 compared to healthy individuals. This suggests a potential genetic link between PMR and elderly-onset rheumatoid arthritis.

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Area of Science:

  • Immunogenetics
  • Rheumatology
  • Human Leukocyte Antigens (HLA)

Background:

  • Polymyalgia rheumatica (PMR) is an inflammatory condition primarily affecting older adults.
  • The immunogenetic factors contributing to PMR pathogenesis remain incompletely understood.
  • Previous studies have suggested associations between certain HLA antigens and PMR.

Purpose of the Study:

  • To investigate the distribution of HLA-D region antigens in patients diagnosed with polymyalgia rheumatica (PMR).
  • To explore potential immunogenetic similarities between PMR and late-onset rheumatoid arthritis (LORA).

Main Methods:

  • Oligonucleotide typing was used to define HLA-D region antigens.
  • Genomic DNA from 17 PMR patients and healthy controls was amplified using polymerase chain reaction (PCR).

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  • Statistical analysis, including relative risk (RR) calculation, was performed to compare antigen frequencies.

    • Main Results:

    • A significantly higher prevalence of HLA-DR4 was observed in PMR patients (70.6%) compared to controls (22.9%) (p < 0.0002; RR = 8.10).
    • The combined frequency of HLA-DR1 and/or DR4 was also significantly elevated in PMR patients (82.4%) versus controls (35.7%) (p < 0.0006; RR = 8.40).
    • The HLA-DR4 subtype Dw13 was found at a significantly higher frequency in PMR patients (29.4%) than in controls (4.3%) (p < 0.002; RR = 9.30).

    Conclusions:

    • The study findings suggest a strong association between HLA-DR4, particularly the Dw13 subtype, and polymyalgia rheumatica.
    • The observed immunogenetic profile in PMR patients indicates potential similarities with late-onset rheumatoid arthritis.
    • Further confirmation by other researchers is warranted to validate these findings.