Gene-Environment Interaction Between HLA-DRB1 Shared Epitope and Occupational Textile Dust Exposure In The Risk Of ACPA-Positive Rheumatoid Arthritis In Female Patients: Evidence From The Malaysian Epidemiological Investigation Of Rheumatoid Arthritis Case-Control Study

Chun Lai Too^1,2, Nor Asiah Muhamad¹, Leonid Padyukov³, Lars Alfredsson⁴, Camilla Bengtsson⁵, Lars Klareskog⁶ and Shahnaz Murad⁷, ¹Institute for Medical Research, Jalan Pahang.Kuala Lumpur, Malaysia, Kuala Lumpur, Malaysia, ²Karolinska Institutet. Department of Medicine. Stockholm, Sweden, Stockholm, Sweden, ³Rheumatology Unit, Karolinska University Hospital, Solna, Karolinska Institutet, Stockholm, Sweden, ⁴Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden, ⁵Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden, ⁶Rheumatology Unit, Department of Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden, ⁷Institute for Medical Research, Jalan Pahang, Kuala Lumpur, Malaysia

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: ACPA, environmental factors and rheumatoid arthritis (RA)

Session Information

Title: ARHP Epidemiology and Public Health

Session Type: Abstract Submissions (ARHP)

Background/Purpose:

Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disease with interacting genetic and environmental factors contributing to its etiology. In this study, we investigated the association between textile dust exposure and the risk of developing RA in the Malaysian population.

Methods:

The RA patients and controls were from the Malaysian Epidemiological Investigation of rheumatoid arthritis (MyEIRA) case-control study. The data from a total of 910 female patients with early RA and 910 age matched female population controls were analyzed. Information from interview-reported occupational exposure to textile dust defined as exposed / never exposed was examined for association between occupational textile dust exposure and the risk of developing anti-citrullinated protein antibodies (ACPA)-positive and negative RA. The odds ratio (OR) with 95% confidence interval (CI) was calculated. Interaction was evaluated by calculating attributable proportion (AP) due to interaction, with 95% CIs.

Results:

Our data showed that occupational exposure to textile dust was significantly associated with an increased risk of developing RA among female patients compared to female controls (OR=3.16, 95% CI 1.71-5.83). Stratification analysis by ACPA status demonstrated significantly increased risk for developing both the ACPA-positive RA (OR=2.64, 95% CI 1.36-5.13) and ACPA-negative RA (OR=4.43, 95% CI 2.15-9.13) among female patients. We observed a strong association and interaction between occupational textile dust exposure and SE-positive for the risk of developing ACPA-positive RA in Malaysian female patients (OR=35.49, 95% CI 4.67-269.82; AP=0.85, 95% CI 0.53-1.16).

Conclusion:

This is the first study demonstrating that the risk of developing ACPA-positive RA in female patients is associated with a strong gene-environment interaction between occupational textile dust exposure and HLA-DRB1 shared epitope in an ethnically diverse Malaysian population.

Disclosure:

C. L. Too,
None;

N. A. Muhamad,
None;

L. Padyukov,
None;

L. Alfredsson,
None;

C. Bengtsson,
None;

L. Klareskog,

No own commercial interests,

S. Murad,
None.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/gene-environment-interaction-between-hla-drb1-shared-epitope-and-occupational-textile-dust-exposure-in-the-risk-of-acpa-positive-rheumatoid-arthritis-in-female-patients-evidence-from-the-malaysian-ep/