Lv Shuang, Li Yiming, Sun Bojian, Jing Yu, Wang Xing, Gu Zhanqing, Wang Bailiang, Xiao Cheng
Department of Rheumatology, the First Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.
Department of Cardiovascular, the First Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.
Appl Clin Genet. 2024 Oct 19;17:159-169. doi: 10.2147/TACG.S472418. eCollection 2024.
Rheumatoid arthritis (RA) is a systemic autoimmune disease with an obscure pathogenesis. This study aims to identify the susceptibility conferred by specific single nucleotide polymorphisms (SNPs), namely rs17548629 within the RIPK1 gene and rs10094579 within the RIPK2 gene, in RA. Additionally, it investigates the associations between inflammatory markers and biochemical parameters at various stages of the disease.
We analyzed 394 patients with RA and 258 normal controls (NCs), examining SNPs within the RIPK1 (rs17548629) and RIPK2 (rs10094579) genes using polymerase chain reaction (PCR) and sequencing techniques. Profiles of RA patients were evaluated for inflammatory markers, including C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), as well as biochemical parameters such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea, glucose, uric acid, and creatinine. Additionally, disease-specific indicators included cyclic citrullinated peptide (CCP), rheumatoid factor (RF), antinuclear antibodies (ANA), and anti-keratin antibodies. The Disease Activity Score 28 (DAS28), based on ESR, was used to categorize RA patients into groups of high, moderate, or low disease activity.
We found a significant association between the RIPK1 rs17548629 genotype and RA in the additive model ( < 0.001; OR = 3.23), over-dominant model ( < 0.001; OR = 0.27), and dominant model ( < 0.001; OR = 3.94). The frequency of the C allele at rs17548629 was significantly higher in NCs than in RA patients ( < 0.001; OR = 0.322). When compared with normal controls, the RIPK1 rs17548629 genotype demonstrated significant associations with both anti-CCP-positive RA patients ( < 0.001) and anti-CCP-negative RA patients ( < 0.001). Similarly, this genotype was associated with RF-positive RA patients ( < 0.001). Furthermore, the RIPK2 rs10094579 genotype was significantly associated with CRP levels in RA patients with low disease activity in the over-dominant model ( = 0.029; OR = 0.065, adjusted for age and sex).
The presence of the RIPK1 rs17548629 genotype is associated with RA under additive, co-dominant, and dominant models. The T allele mutation at rs17548629 increases the risk of RA in the Chinese population. The RIPK1 rs17548629 genotype was identified as being associated with RF-positive RA patients, whereas no significant association was observed in RF-negative individuals. These findings suggest that this SNP may modulate the risk of RA in an RF-dependent manner. Furthermore, the RIPK2 rs10094579 genotype correlates with CRP levels in RA patients exhibiting low disease activity. This association underscores the necessity for caution when reducing the dosage of therapy in RA patients with low disease activity who carry the CA genotype at RIPK2 rs10094579. Additional research is warranted to explore other genotypes that may influence RA susceptibility and to refine potential treatment strategies.
类风湿关节炎(RA)是一种发病机制不明的全身性自身免疫性疾病。本研究旨在确定RIPK1基因内的特定单核苷酸多态性(SNP)即rs17548629和RIPK2基因内的rs10094579赋予RA的易感性。此外,还研究了疾病不同阶段炎症标志物与生化参数之间的关联。
我们分析了394例RA患者和258例正常对照(NC),采用聚合酶链反应(PCR)和测序技术检测RIPK1(rs17548629)和RIPK2(rs10094579)基因内的SNP。评估RA患者的炎症标志物,包括C反应蛋白(CRP)和红细胞沉降率(ESR),以及丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、尿素、葡萄糖、尿酸和肌酐等生化参数。此外,疾病特异性指标包括环瓜氨酸肽(CCP)、类风湿因子(RF)、抗核抗体(ANA)和抗角蛋白抗体。基于ESR的疾病活动评分28(DAS28)用于将RA患者分为高、中、低疾病活动组。
我们发现RIPK1 rs17548629基因型与RA在加性模型(P<0.001;OR = 3.23)、超显性模型(P<0.001;OR = 0.27)和显性模型(P<0.001;OR = 3.94)中存在显著关联。rs17548629位点C等位基因在NC中的频率显著高于RA患者(P<0.001;OR = 0.322)。与正常对照相比,RIPK1 rs17548629基因型与抗CCP阳性RA患者(P<0.001)和抗CCP阴性RA患者(P<0.001)均有显著关联。同样,该基因型与RF阳性RA患者(P<0.001)相关。此外,在超显性模型中,RIPK2 rs10094579基因型与低疾病活动度RA患者的CRP水平显著相关(P = 0.029;OR = 0.065,经年龄和性别校正)。
RIPK1 rs17548629基因型在加性、共显性和显性模型下与RA相关。rs17548629位点的T等位基因突变增加了中国人群患RA的风险。RIPK1 rs17548629基因型被确定与RF阳性RA患者相关,而在RF阴性个体中未观察到显著关联。这些发现表明该SNP可能以RF依赖的方式调节RA的风险。此外,RIPK2 rs10094579基因型与低疾病活动度RA患者的CRP水平相关。这种关联强调了对于携带RIPK2 rs10094579位点CA基因型的低疾病活动度RA患者在减少治疗剂量时需谨慎的必要性。有必要进行更多研究以探索可能影响RA易感性的其他基因型并完善潜在的治疗策略。