Arthritis Research & Therapy

official impact factor 4.36

Open Access Research article

Association between the TNFRII 196R allele and diagnosis of rheumatoid arthritis

Vincent Goëb1,2*, Philippe Dieudé3, Olivier Vittecoq1,2, Othmane Mejjad1, Jean-François Ménard4, Marlène Thomas2, Danièle Gilbert2, Patrick Boumier5, Sophie Pouplin1, Alain Daragon1,2, Patrice Fardellone5, François Tron2, François Cornélis3 and Xavier Le Loët1,2

Author Affiliations

1 Rheumatology Department, University Hospital of Rouen, Rouen, France

2 Inserm U519, IFRMP 23, Faculty of Medicine, Rouen, France

3 GenHotel, University of Evry-Paris VII, Faculty of Lariboisière-Saint Louis, Evry-Genopole and Unité de Génétique clinique, University Hospital of Lariboisière, APHP, Paris, France

4 Biostatistics Department, University Hospital of Rouen, Rouen, France

5 Rheumatology Department, University Hospital of Amiens, Amiens, France

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Arthritis Research & Therapy 2005, 7:R1056-R1062 doi:10.1186/ar1777

Published: 29 June 2005

Abstract

Tumour necrosis factor (TNF)-α plays a key role in the pathogenesis of rheumatoid arthritis (RA). It binds to two receptors, namely TNF receptor (TNFR)I and TNFRII. Several studies have suggested an association between TNFRII 196R/R genotype and RA. The objective of the present study was to evaluate the predictive value of the TNFRII 196R allele for RA diagnosis and prognosis in a cohort of patients with very early arthritis. We followed up a total of 278 patients recruited from the community, who had swelling of at least two joints that had persisted for longer than 4 weeks but had been evolving for less than 6 months, and who had not received disease-modifying antirheumatic drugs or steroid therapy. At 2 years, patients were classified according to the American College of Rheumatology criteria. All patients were genotyped with respect to TNFRII 196M/R polymorphism. Radiographs of hands and feet (read according to the modified Sharp method) and the Health Assessment Questionnaire were used to quantify structural and functional severity. The cohort of 278 patients was found to include 156 and 122 RA and non-RA patients, respectively. The TNFRII 196R allele was found to be associated with RA (P = 0.002). However, progression of radiographic severity and Health Assessment Questionnaire scores over 1 year did not differ between carriers of the 196R allele and noncarriers. Our findings suggest that the TNFRII 196R allele may be associated with RA diagnosis but that it does not predict early radiographic progression or functional severity in patients with very early, unclassified arthritis.