PubMed Health⌕ Search

Biomedical subjects

C M Deighton

Publications and source records attributed to C M Deighton.

At least 37 records · Page 2Linked to original sources
PubMed1993

Linkage of rheumatoid arthritis with HLA.

OBJECTIVE: To determine whether HLA exerts a variable influence on the predisposition of siblings of probands with clinically mild and severe rheumatoid arthritis (RA). METHOD: Calculation of crude and adjusted odds ratios for concordance rates in sibships sharing two, one and no HLA haplotypes with a proband with clinically mild and severe RA, and HLA haplotype sharing in multiply affected sibships in the same clinical groups. RESULTS: Compared with a reference value of 1.0 in siblings sharing no HLA haplotypes with a proband with mild RA, siblings sharing two HLA haplotypes with a severely affected proband had a sibship concordance rate odds ratio of 9.7 (95% confidence interval 2.5 to 38.2). When adjusted for age, sex, and disease duration, the odds ratio was 7.6 (1.8 to 32.4). No other sibships showed concordance rates which were significantly higher than the reference group. HLA haplotype sharing in multiply affected sibships in which the proband had severe RA deviated significantly from random (two, one, and no HLA haplotypes shared: 53.3, 40, and 6.7%, respectively; expected 25, 50, and 25%), whereas in sibships of probands with mild RA they did not (14.6, 70.8, and 14.6%). CONCLUSIONS: In the predisposition of siblings to RA, sharing HLA haplotypes with a proband is only important if the proband has severe RA. Mild RA is not genetically linked to the HLA region.

Adult↗
PubMed1992

Rheumatoid arthritis in thyroid disease positive and negative same-sexed sibships.

A total of 249 rheumatoid arthritis (RA) same-sexed sibships were clinically documented, HLA-typed and had auto-antibody screens performed. Sibships with a history of thyroid disease (TD) or significant thyroid antibodies were categorized as 'thyroid' sibships and the rest 'non-thyroid'. TD was more common in the female RA sibships than controls, particularly in the RA probands. The presence of thyroid microsomal antibody, but not thyroglobulin antibody, was significantly higher in all members of the female sibships, and in the probands and non-RA siblings of the male sibships. Comparing the thyroid and non-thyroid sibships, there was no significant difference in the distribution of HLA haplotypes in RA-RA sibling pairs, and HLA-DR status, clinical or immunological characteristics of the probands. These data do not support the concept that predisposition to RA in thyroid sibships might be non-DR4 or non-HLA linked.

Arthritis, Rheumatoid↗
PubMed1992

Anti-Proteus antibodies in rheumatoid arthritis same-sexed sibships.

One hundred and forty-two RA patients and 121 of their healthy same-sexed siblings were tested for antibodies (Abs) to Proteus mirabilis and Escherichia coli by indirect immunofluorescence. Eighty-five individuals had active RA (CRP greater than 10 mg/l) and 57 inactive RA. The anti-Proteus Ab titre in the active RA group was significantly higher than in the inactive RA and non-RA group (P less than 0.0001 in both cases). Anti-Proteus Abs were significantly elevated in 30 individuals with active RA compared with their healthy HLA-identical same-sexed siblings (P less than 0.001). In 42 HLA-DR4 positive and 15 HLA-DR4 negative active RA patients, the Ab titre was non-significantly higher in the former group. Anti-E. coli Abs were not significantly elevated in any of the groups. Longitudinal data on 36 RA patients demonstrated a significant positive correlation between changes in CRP and changes in anti-Proteus antibody titres (r = 0.52, P less than 0.001). These observations require an explanation.

Antibodies, Bacterial↗
PubMed1992

Specificity of the proteus antibody response in rheumatoid arthritis.

Antibodies to proteus were determined by indirect immunofluorescence in 146 serum samples from patients with rheumatoid arthritis (RA). An autoantibody screen was performed in the same samples and in 52 of these antibody titres to the viruses influenza A, adenovirus, rubella, and parvovirus were determined. There was no significant correlation between proteus antibodies and any of the other antibodies tested. Dividing the samples into those from patients with active (C reactive protein > 10 mg/l) and inactive RA showed that the only antibodies to be significantly increased in active RA were the proteus antibodies. These observations suggest that the proteus antibody response in RA is specific.

Acute Disease↗
PubMed1992

P blood group phenotype, proteus antibody titres, and rheumatoid arthritis.

The interrelationships between P blood group phenotype, proteus antibodies and rheumatoid arthritis (RA) were investigated in 140 patients with RA and 114 of their siblings who did not have RA. In the group with RA P2 subjects had significantly higher titres of proteus antibodies than P1 patients. This was not observed in the group without RA, or for antibodies to Escherichia coli. Although C reactive protein was the best predictor of proteus antibodies in the group with RA, the P blood group had an independent and significant influence. These observations suggest a testable model in which asymptomatic carriage of proteus in the urinary tract may lead to antibody production, which in turn may be important in the pathogenesis of RA.

Acute Disease↗
PubMed1992

Contribution of inherited factors to rheumatoid arthritis.

A total of 231 sibships of the same sex (186 female, 45 male), in which the proband had classical or definite rheumatoid arthritis (RA) have been selected from rheumatology clinics. Each sibship member was questioned about symptomatic joints, which were then examined. Hospital records, radiographs, and rheumatoid factor measurements allowed each sibling to be classified as having classical, definite, probable, or no RA. Each sibling was typed for HLA-A and B and was classified as sharing two, one, or zero HLA haplotypes with the proband. Concordance rates for classical and definite RA were three times greater in sibships of women than of men (9.3 v 3.0%). Concordance rates in HLA identical sibships were twice those in hemi- and non-identical sibships (15.5, 7.1, and 5.2%, respectively). Probable RA was more common in male and HLA hemi- and non-identical sibships. These results suggest that female sex and the two inherited HLA haplotypes are important for the presence and expression of RA. Although environmental factors may be shared more in twins than siblings, a concordance rate of 20.5% in seropositive HLA identical sibships of the same sex compared with 30% in monozygotic twins suggests that sex and HLA type account for about two thirds of the inherited risk of RA.

Arthritis, Rheumatoid↗
PubMed1992

Influence of the severity of rheumatoid arthritis on sex differences in health assessment questionnaire scores.

In a study of 284 consecutive patients with rheumatoid arthritis attending hospital clinics a previous observation that female patients score higher on the Stanford Health Assessment Questionnaire (HAQ) than men was confirmed. A clinical disease severity score and the spread/severity index also showed that women had more severe disease. Although scores in some categories of the HAQ were higher in women, they were not disproportionately so, providing no evidence that domestic categories of the HAQ are biased against women. A multiple regression analysis showed that the spread/severity index score was the best predictor of HAQ scores, with sex making no significant contribution. The severity of the disease adequately explained the higher HAQ scores in female patients with rheumatoid arthritis.

Arthritis, Rheumatoid↗
PubMed1992

Effect of disease severity on rheumatoid arthritis concordance in same sexed siblings.

To assess the factors in a proband with rheumatoid arthritis (RA) that might predict the occurrence of the disease in siblings, 240 same sexed sibships (190 female, 50 male) in which the proband had classical or definite RA were clinically and immunologically documented. Sibship concordance rates were consistently higher for features of severe disease in the proband, reaching statistical significance for a clinical score of disease severity (the SS index). This trend for increasing disease severity to be associated with increasing sibship concordance rates could not be accounted for by age or disease duration of the proband. These results suggest that siblings of probands with severe RA are at greater risk of developing RA than those of probands with mild disease.

Age Factors↗
PubMed1992

Sex hormones in postmenopausal HLA-identical rheumatoid arthritis discordant sibling pairs.

Dehydroepiandrosterone sulfate (DHEAS), testosterone, androstenedione, 17-beta estradiol and sex hormone binding globulin have been assayed in 50 HLA-identical postmenopausal rheumatoid arthritis (RA) discordant sibling pairs. The only difference was for DHEAS, siblings with RA having a significantly lower level than their sisters. However, in 68 patients with RA, the level of DHEAS inversely correlated with disease duration, a radiographic grading score, the Health Assessment Questionnaire score, duration of morning stiffness, and a clinical score of disease activity and severity (the Spread/Severity index). These observations, taken with that of previous work on DHEAS, suggest that low levels may be a consequence of RA rather than predisposing to the disease. The role of sex hormones in RA will have to be approached in alternative ways.

Aged↗
PubMed1992

What factors distinguish probands from multicase rheumatoid arthritis same sex sibships from sporadic disease?

Thirty-two of 243 same sex sibships in which the proband had rheumatoid arthritis (RA) had at least one same sex sibling with RA ("familial" RA) and 211 did not ("sporadic" RA). The most important factors accounting for familial RA were the sibship size, and the proportion of siblings sharing both HLA haplotypes with the proband. Demographic and clinical details, autoantibodies and HLA-DR status were similar between the 2 groups, with the exceptions of regular use of artificial teardrops, and involvement of distal interphalangeal joints, which were both more prevalent in familial RA. The extrapolation of results from familial to sporadic RA appears to be justified.

Arthritis, Rheumatoid↗