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YACKOV BERKUN, IMAN ABOU ATTA, ALAN RUBINOW, HEDI ORBACH, DAVID LEVARTOVSKY, SUHAIL AAMAR, OFER ARBEL, RIVKA DRESNER-POLLAK, GIDEON FRIEDMAN, and ARIE BEN-YEHUDA
ABSTRACT. Methods. A cross-sectional study was performed on 86 MTX-treated RA patients, consisting of a clinical interview and physical examination to determine disease activity and MTX-related adverse reactions. Genotype analysis of the MTR gene was performed. Fasting plasma tHcy, serum folate, and vitamin B12 levels were measured. Allele and genotype distributions were compared to a healthy control group. Results. The frequency of the 2756GG genotype (16.3%) in the RA study group was higher than that expected in the general population (3.6%; p < 0.000001). This genotype was associated with MTX-induced accelerated rheumatoid nodulosis (MIARN). No association of disease activity variables or plasma homocysteine with MTR A2756G polymorphisms was observed. The MTR 2756GG genotype, low plasma vitamin B12 levels, and the presence of rheumatoid nodules predicted MIARN. No association of nodulosis with any other indicator of disease activity or medical treatment was found. Conclusion. In our population of MTX-treated RA patients the 2756GG genotype of the MTR gene was more common than expected and was associated with MIARN. (First Release July 1 2007; J Rheumatol 2007;34:1664-9) Key Indexing Terms:
RHEUMATOID ARTHRITIS
From the Department of Pediatrics, Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel. Y. Berkun, MD, Senior Physician, Department of Pediatrics, Safra Children's Hospital, Sheba Medical Center, Lecturer, Pediatrics, Sackler Faculty of Medicine, Tel-Aviv University; I. Abou Atta, BSc, Research Associate, Department of Medicine, Hadassah University Hospital, Jerusalem; A. Rubinow, MD, Head, Rheumatology Unit, Hadassah University Hospital, Associate Professor of Medicine, Hebrew University–Hadassah Medical School, Jerusalem; H. Orbach, MD, Head, Department of Medicine, Wolfson Medical Center, Holon; D. Levartovsky, MD, Senior Physician, Rheumatology Department, Sourasky Medical Center, Tel Aviv; S. Aamar, MD, Senior Physician, Department of Internal Medicine; O. Arbel, MD, Department of Internal Medicine C, Hadassah University Hospital; R. Dresner-Pollak, MD, Senior Physician, Department of Internal Medicine C, Hadassah University Hospital, Senior Lecturer, Hebrew University–Hadassah Medical School; G. Friedman, MD, Head, Medical Day Care Unit and Geriatric Unit, Hadassah University Hospital, Professor of Medicine, Hebrew University–Hadassah Medical School; A. Ben-Yehuda, MD, Head, Department of Internal Medicine C, Hadassah University Hospital, Associate Professor of Medicine, Hebrew University–Hadassah Medical School. Address reprint requests to Dr. Y. Berkun, Pediatric Rheumatology, Department of Pediatrics, Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, 52621 Israel. E-mail: berkun@md.huji.ac.il Accepted for publication March 20, 2007. |
