title: Familial and genetic aspects of spondyloarthropathy.
abstract: Predisposition to SpA is largely determined by genetic factors including HLA-B27 and other as yet unknown genes that might be tracked by a positional cloning approach. Analysis performed on a large cohort of SpA multiplex families revealed that the different articular and extra-articular inflammatory manifestations comprising the SpA spectrum were linked together, implying that they were determined by a shared set of factors, including HLA-B27. The variety of phenotypes appeared to be related to ubiquitous and secondary factors. Hence, SpA appeared to be more homogenous than previously thought and should be regarded as a unique disease. This conclusion also implies that genetic studies should be performed on the whole group. Such an approach allowed identification of HLA-DR4 as a gene contributing to SpA predisposition independently of linkage disequilibrium with HLA-B27. A significant role for CARD15/NOD2 gene in predisposition to SpA was ruled out, in agreement with the hypothesis that the inflammatory bowel disease in SpA is determined by factors different than those responsible for isolated Crohn's disease.
authors.affiliation: Department of Rheumatology, Medical University of Paris-Ile-de-France-Ouest, Hôpital Ambroise Paré, 9 avenue Charles de Graulle, 92100 Boulogne Billancourt, Paris, France. maxime.breban@apr.ap-hop-paris.fr
authors.forename: Maxime
authors.initials: M
authors.lastname: Breban
authors.forename: Roula
authors.initials: R
authors.lastname: Said-Nahal
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Hugot
authors.forename: Corinne
authors.initials: C
authors.lastname: Miceli-Richard
mesh_terms: D005192:Family Health; D020022:Genetic Predisposition to Disease; D006801:Humans; D025242:Spondylarthropathies / Q000235:genetics*