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The objective of the study was to investigate the genetic contribution to the clinical expression of rheumatoid arthritis (RA) by comparison of disease features in RA-concordant monozygotic (MZ) twin pairs. Fourteen RA-concordant MZ twin pairs recruited from a nation-wide study were examined to determine the degree of similarity in: (a) age of disease onset; (b) pattern of joint involvement; (c) pattern of extra-articular disease; (d) toxic reactions to drugs; (e) disease course; and (f) serology for rheumatoid factor (RF) and antinuclear antibody. There was considerable within-pair diversity in the variables studied. Some similarity within twin pairs was observed for the ages at disease onset (R = 0.63), presence of erosive changes (kappa = 0.61) and the presence of IgM RF (R = 0.87). No important similarity was seen, however, in the pattern of joint involvement, the occurrence of extra-articular disease, adverse drugs reactions, clinical disease course and reported disability level. There is heterogeneity in the genetic contribution to the clinical expression of RA. The overall lack of similarity for the majority of clinical variables indicates the importance of non-genetic factors on the expression of disease.

Original publication

DOI

10.1093/rheumatology/34.3.215

Type

Journal article

Journal

British journal of rheumatology

Publication Date

03/1995

Volume

34

Pages

215 - 220

Addresses

ARC Epidemiology Research Unit, University of Manchester, London.

Keywords

Humans, Arthritis, Rheumatoid, Immunoglobulin M, Rheumatoid Factor, Age Factors, Twins, Monozygotic, Phenotype, Genetic Heterogeneity, Aged, Middle Aged, Female, Male