Epidemiología genética de la artritis reumatoide: ¿qué esperar de América Latina?

Abstract

Rheumatoid arthritis is a chronic and systemic autoimmune disease characterized byinflammation and destruction of the synovial joints. It affects approximately 0.5% of the Latin-American population and is three times more common in women than in men. Evidence offamilial aggregation (?s=2-17) was the first indication of a genetic susceptibility to disease. Asin other autoimmune diseases, it has a complex genetic basis. Results from whole-genomescans indicate that the HLA region contains a significant and consistent set of linked loci.However, HLA accounts for only one-third of the genetic susceptibility of disease, indicatingthat non-HLA genes are also involved in the disease susceptibility. In Latin-America, associationwith HLA-DRB1*0404 and TNF -308A alleles has been uniformly established; however, manyother candidate genes remain to be studied. The identification of genetic factors conferringsusceptibility to rheumatoid arthritis will contribute to the knowledge of the pathogenicmechanisms, ability to predict its occurrence, the development of diagnostic tools, prognosis,and treatment. The genetic epidemiology of rheumatoid arthritis is herein reviewed; a set ofrecommendations is provided for the design, analysis and interpretation of genetic associationstudies in the context of Latin-American populations.