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Titolo:
What is the natural history of rheumatoid arthritis?
Autore:
Ollier, WER; Harrison, B; Symmons, D;
Indirizzi:
Univ Manchester, Sch Med, ARC Epidemiol Unit, Manchester M13 9PT, Lancs, England Univ Manchester Manchester Lancs England M13 9PT M13 9PT, Lancs, England N Manchester Healthcare NHS Trust, Manchester, Lancs, England N ManchesterHealthcare NHS Trust Manchester Lancs England ancs, England
Titolo Testata:
BEST PRACTICE & RESEARCH IN CLINICAL RHEUMATOLOGY
fascicolo: 1, volume: 15, anno: 2001,
pagine: 27 - 48
SICI:
1521-6942(200103)15:1<27:WITNHO>2.0.ZU;2-N
Fonte:
ISI
Lingua:
ENG
Soggetto:
DISEASE-ACTIVITY SCORE; FOLLOW-UP; CIGARETTE-SMOKING; INFLAMMATORY POLYARTHRITIS; RADIOGRAPHIC DAMAGE; ALCOHOL-CONSUMPTION; PROGNOSTIC FACTORS; HLA-DRB1 ALLELES; ONSET; DISABILITY;
Keywords:
inflammatory polyarthritis; rheumatoid arthritis; epidemiology; risk factors; prognosis; genetics;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
75
Recensione:
Indirizzi per estratti:
Indirizzo: Symmons, D Univ Manchester, Sch Med, ARC Epidemiol Unit, Oxford Rd, Manchester M13 9PT, Lancs, England Univ Manchester Oxford Rd Manchester Lancs England M13 9PT land
Citazione:
W.E.R. Ollier et al., "What is the natural history of rheumatoid arthritis?", BEST PR R C, 15(1), 2001, pp. 27-48

Abstract

Inflammatory polyarthritis can be a self-limiting disease, develop into rheumatoid arthritis (RA) or differentiate into another form of chronic arthritis. It remains a clinical and scientific challenge to understand the relationship between these phenotypes. determine their aetiologies and predict the course and outcome for individual patients. Even patients labelled as having RA show a wide spectrum of clinical phenotypes. Disease definition isa major problem in studying the aetiology of PA as currently used classification criteria were derived using patients with established disease. RA isthought to result from the combination of genetic susceptibility and exposure to an appropriate environmental trigger. The genetic component is probably oligogenic. The association with HLA has been known for over 25 years. RA is now thought to be associated with a conserved sequence of amino acidsin a number of HLA-DRBI alleles, called the RA shared epitope. However, the shared epitope appears to be associated with PA chronicity and severity more than with susceptibility. Other potential RA susceptibility genes include IL-I, aromatase, corticotropin-releasing hormone and a region on the X chromosome. Hormonal and reproductive factors also influence RA susceptibility and severity. RA is more common in women than men, especially before themenopause. Men may be protected by hormonal factors and require a strongergenetic component to develop disease. Although infectious triggers of RA have long been suspected, no definitive evidence has been obtained. Previousblood transfusion, smoking and obesity are also possible risk factors, Chronicity and remission are important aspects of the natural history of earlyPA. Although we can identify patients at risk of adverse prognosis with some accuracy, we remain unable to predict remission. Functional disability and radiological damage are the most studied outcomes in RA. Radiological damage often occurs early in the course of RA, bur patients may show erosion for the first time several years after symptom onset. Many studies have demonstrated a relationship between HLA and features of severe RA in established patients. This appears to be related to gene dosage.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/01/20 alle ore 18:44:22