Specific interaction between genotype, smoking and autoimmunity to citrullinated α-enolase in the etiology of rheumatoid arthritis

H Mahdi, BA Fisher, H Källberg, D Plant, V Malmström… - Nature …, 2009 - nature.com
H Mahdi, BA Fisher, H Källberg, D Plant, V Malmström, J Rönnelid, P Charles, B Ding…
Nature genetics, 2009nature.com
Gene-environment associations are important in rheumatoid arthritis (RA) susceptibility, with
an association existing between smoking, HLA-DRB1'shared epitope'alleles, PTPN22 and
antibodies to cyclic citrullinated peptides (CCP),. Here, we test the hypothesis that a subset
of the anti-CCP response, with specific autoimmunity to citrullinated α-enolase,, accounts for
an important portion of these associations. In 1,497 individuals from three RA cohorts,
antibodies to the immunodominant citrullinated α-enolase CEP-1 epitope were detected in …
Abstract
Gene-environment associations are important in rheumatoid arthritis (RA) susceptibility, with an association existing between smoking, HLA- DRB1 'shared epitope' alleles, PTPN22 and antibodies to cyclic citrullinated peptides(CCP),. Here, we test the hypothesis that a subset of the anti-CCP response, with specific autoimmunity to citrullinated α-enolase,, accounts for an important portion of these associations. In 1,497 individuals from three RA cohorts, antibodies to the immunodominant citrullinated α-enolase CEP-1 epitope were detected in 43–63% of the anti-CCP–positive individuals, and this subset was preferentially linked to HLA-DRB1*04. In a case-control analysis of 1,000 affected individuals and 872 controls, the combined effect of shared epitope, PTPN22 and smoking showed the strongest association with the anti-CEP-1–positive subset (odds ratio (OR) of 37, compared to an OR of 2 for the corresponding anti-CEP-1–negative, anti-CCP–positive subset). We conclude that citrullinated α-enolase is a specific citrullinated autoantigen that links smoking to genetic risk factors in the development of RA.
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