{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:46:24Z","timestamp":1791333984314,"version":"4.3.1"},"reference-count":20,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2004,10,8]],"date-time":"2004-10-08T00:00:00Z","timestamp":1097193600000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatism"],"published-print":{"date-parts":[[2004,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The main genetic risk factor for rheumatoid arthritis (RA) is the shared epitope (SE) of HLA\u2013DR, while smoking is an important environmental risk factor. We studied a potential gene\u2013environment interaction between SE genes and smoking in the etiology of the 2 major subgroups of RA: rheumatoid factor (RF)\u2013seropositive and RF\u2010seronegative disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A population\u2010based case\u2013control study involving incident cases of RF\u2010seropositive and RF\u2010seronegative RA (858 cases and 1,048 controls) was performed in Sweden. Cases and controls were classified according to their cigarette smoking status and HLA\u2013DRB1 genotypes. The relative risk of developing RA was calculated for different gene\/smoking combinations and was compared with the relative risk in never smokers without SE genes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The relative risk of RF\u2010seropositive RA was 2.8 (95% confidence interval [95% CI] 1.6\u20134.8) in never smokers with SE genes, 2.4 (95% CI 1.3\u20134.6) in current smokers without SE genes, and 7.5 (95% CI 4.2\u201313.1) in current smokers with SE genes. Smokers carrying double SE genes displayed a relative risk of RF\u2010seropositive RA of 15.7 (95% CI 7.2\u201334.2). The interaction between smoking and SE genes was significant, as measured by the attributable proportion due to interaction, which was 0.4 (95% CI 0.2\u20130.7) for smoking and any SE, and 0.6 (95% CI 0.4\u20130.9) for smoking and a double SE. Neither smoking nor SE genes nor the combination of these factors increased the risk of developing RF\u2010seronegative RA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The disease risk of RF\u2010seropositive RA associated with one of the classic genetic risk factors for immune\u2010mediated diseases (the SE of HLA\u2013DR) is strongly influenced by the presence of an environmental factor (smoking) in the population at risk.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.20553","type":"journal-article","created":{"date-parts":[[2004,10,8]],"date-time":"2004-10-08T22:00:29Z","timestamp":1097272829000},"page":"3085-3092","source":"Crossref","is-referenced-by-count":547,"title":["A gene\u2013environment interaction between smoking and shared epitope genes in HLA\u2013DR provides a high risk of seropositive rheumatoid arthritis"],"prefix":"10.1002","volume":"50","author":[{"given":"Leonid","family":"Padyukov","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrik","family":"Stolt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Alfredsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Klareskog","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2004,10,8]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/nri885"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780301102"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780390504"},{"key":"e_1_2_6_5_2","first-page":"47","article-title":"Current tobacco smoking, formal education, and the risk of rheumatoid arthritis","volume":"26","author":"Uhlig T","year":"1999","journal-title":"J Rheumatol"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.62.9.835"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.10174"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780310302"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0039.1996.tb02623.x"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0039.1992.tb01940.x"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a112220"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a113015"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-199209000-00012"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780401106"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199910)42:10<2174::AID-ANR19>3.0.CO;2-G"},{"key":"e_1_2_6_16_2","first-page":"1024","article-title":"HLA\u2010DRB1 genotype influences risk for and severity of rheumatoid arthritis","volume":"26","author":"Meyer JM","year":"1999","journal-title":"J Rheumatol"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0952-7915(99)00033-3"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.95.11.6383"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0041-1345(99)00047-0"},{"key":"e_1_2_6_20_2","first-page":"1830","article-title":"Smoking and risk of rheumatoid arthritis","volume":"20","author":"Heliovaara M","year":"1993","journal-title":"J Rheumatol"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1186\/ar750"}],"container-title":["Arthritis &amp; Rheumatism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fart.20553","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/art.20553","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,23]],"date-time":"2023-11-23T13:06:43Z","timestamp":1700744803000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/art.20553"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,10]]},"references-count":20,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2004,10]]}},"alternative-id":["10.1002\/art.20553"],"URL":"https:\/\/doi.org\/10.1002\/art.20553","archive":["Portico"],"relation":{},"ISSN":["0004-3591","1529-0131"],"issn-type":[{"value":"0004-3591","type":"print"},{"value":"1529-0131","type":"electronic"}],"subject":[],"published":{"date-parts":[[2004,10]]}}}