Influence of non-inherited maternal HLA antigens on occurrence of rheumatoid arthritis

Lancet. 1993 Jan 23;341(8839):200-2. doi: 10.1016/0140-6736(93)90065-o.


Many HLA-associated diseases occur in patients not carrying the putative predisposing antigen. The suggestion that this might be due to disease heterogeneity is not sufficiently supported by available data. We hypothesise that HLA-DR4-associated genetic susceptibility to rheumatoid arthritis is due to an effect of DR4 on T-cell receptor repertoire expression and that the presence of antigen in the mother is capable of producing this effect in her children, even when DR4 is not inherited by them. To investigate this possibility we HLA typed 94 rheumatoid arthritis patients and their parents and 86 control families. An increased frequency, compared with controls, of non-inherited maternal HLA-DR4 was found predominantly in the mothers of DR4-negative patients. Unexpectedly, we also found an increased frequency of non-inherited maternal HLA-DR6 and a decreased frequency of non-inherited maternal HLA-DR3 in the mothers of DR4-positive patients. The results of our analyses are consistent with our hypothesis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Arthritis, Rheumatoid / epidemiology
  • Arthritis, Rheumatoid / genetics*
  • Arthritis, Rheumatoid / immunology
  • Evaluation Studies as Topic
  • Gene Expression
  • Gene Frequency*
  • HLA-DR1 Antigen / genetics*
  • HLA-DR1 Antigen / immunology
  • HLA-DR3 Antigen / genetics*
  • HLA-DR3 Antigen / immunology
  • HLA-DR4 Antigen / genetics*
  • HLA-DR4 Antigen / immunology
  • Histocompatibility Testing
  • Humans
  • Netherlands / epidemiology
  • Pedigree
  • Phenotype
  • T-Lymphocytes / immunology


  • HLA-DR1 Antigen
  • HLA-DR3 Antigen
  • HLA-DR4 Antigen