title: Coeliac disease and rheumatoid arthritis: similar mechanisms, different antigens.
abstract: Rheumatoid arthritis (RA) and coeliac disease are inflammatory diseases that both have a strong association with class II HLAs: individuals carrying HLA-DQ2.5 and/or HLA-DQ8 alleles have an increased risk of developing coeliac disease, whereas those carrying HLA-DR shared epitope alleles exhibit an increased risk of developing RA. Although the molecular basis of the association with specific HLA molecules in RA remains poorly defined, an immune response against post-translationally modified protein antigens is a hallmark of each disease. In RA, understanding of the pathogenetic role of B-cell responses to citrullinated antigens, including vimentin, fibrinogen and α-enolase, is rapidly growing. Moreover, insight into the role of HLAs in the pathogenesis of coeliac disease has been considerably advanced by the identification of T-cell responses to deamidated gluten antigens presented in conjunction with predisposing HLA-DQ2.5 molecules. This article briefly reviews these advances and draws parallels between the immune mechanisms leading to RA and coeliac disease, which point to a crucial role for T-cell-B-cell cooperation in the development of full-blown disease. Finally, the ways in which these novel insights are being exploited therapeutically to re-establish tolerance in patients with RA and coeliac disease are described.
authors.affiliation: Department of Immunohaematology and Blood Transfusion, Leiden University Medical Centre, Albinusdreef 2, Leiden 2333 ZA, Netherlands.
authors.forename: Frits
authors.initials: F
authors.lastname: Koning
authors.affiliation: The University of Queensland Diamantina Institute, Level 6, Translational Research Institute, Princess Alexandra Hospital, 37 Kent Street, Woolloongabba, QLD 4102, Australia.
authors.forename: Ranjeny
authors.initials: R
authors.lastname: Thomas
authors.affiliation: Australian Research Council Centre of Excellence in Advanced Molecular Imaging and Department of Biochemistry and Molecular Biology, School of Biomedical Sciences, Monash University, Clayton, VIC 3800, Australia.
authors.forename: Jamie
authors.initials: J
authors.lastname: Rossjohn
authors.affiliation: Department of Rheumatology, Leiden University Medical Centre, Albinusdreef 2, Leiden 2333 ZA, Netherlands.
authors.forename: Rene E
authors.initials: RE
authors.lastname: Toes
mesh_terms: D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000276:immunology*; D001402:B-Lymphocytes / Q000276:immunology; D002446:Celiac Disease / Q000188:drug therapy / Q000276:immunology*; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D013601:T-Lymphocytes / Q000276:immunology
chemical_list: D006680:HLA Antigens