title: A retrospective study using nail clippings of rheumatoid susceptible alleles of HLA-DRB1 as a prognostic factor in early rheumatoid arthritis.
abstract: OBJECTIVE
  To evaluate whether the number of susceptible factors influences disease progression in Japanese patients diagnosed with early rheumatoid arthritis (RA).
  
  
  METHODS
  Fifty-eight Japanese outpatients (46 female, 12 male; mean age 48.9 yrs) with early RA of less than one year after onset were enrolled in the study. The criteria for early RA (Japanese Ministry of Welfare) were used. DNA was extracted from fingernail clippings and the gene frequencies of HLA-DRB1 alleles were investigated. The degrees of progression of (1) clinical symptoms, (2) laboratory findings, (3) radiographic changes, and (4) magnetic resonance imaging score were analyzed by a comparison of the above at time of diagnosis and at final examination (an average of 14 months after the time of diagnosis).
  
  
  RESULTS
  The frequencies of the susceptible factors (S: 0101, 0401, 0404, 0405, 1001, and 1402) were 17, 3.4, 0.9, 29, 0, and 0%, respectively. The progression of inflammatory autoimmune activity, erosion incidence, and synovial proliferation severity in the S/S group was significantly more rapid than that in the other groups. In the disease activity at each time, the difference between the S/S group and the S/N group was significant, as was that between the S/S group and the N/N group, but the difference between the S/N group and the N/N group was not significant.
  
  
  CONCLUSIONS
  Haplotyping of HLA-DRB1 using the patient's nail clippings may be useful as a prognostic marker for disease progression in early RA.
authors.affiliation: Department of Orthopedic Surgery, School of Medicine, Sapporo Medical University, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Tanaka
authors.forename: T
authors.initials: T
authors.lastname: Masuko
authors.forename: S
authors.initials: S
authors.lastname: Ishii
mesh_terms: D000328:Adult; D000483:Alleles; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000503:physiopathology; D004247:DNA / Q000032:analysis; D004198:Disease Susceptibility; D005260:Female; D005787:Gene Frequency; D006684:HLA-DR Antigens / Q000032:analysis*; D059811:HLA-DRB1 Chains; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009262:Nails / Q000737:chemistry*; D016133:Polymerase Chain Reaction; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D006684:HLA-DR Antigens; D059811:HLA-DRB1 Chains; D004247:DNA