HLA associated with rhaumatoid ahritis
**Core Concept**
HLA (Human Leukocyte Antigen) genes play a crucial role in the immune system by controlling the presentation of peptides to T-cells. Certain HLA alleles are associated with an increased risk of developing autoimmune diseases, including rheumatoid arthritis (RA). This is due to the presentation of self-antigens, leading to an abnormal immune response.
**Why the Correct Answer is Right**
The HLA-DRB1 gene, specifically the shared epitope alleles (e.g., HLA-DRB1*0401, HLA-DRB1*0404), is strongly associated with rheumatoid arthritis. These alleles lead to the presentation of citrullinated peptides to T-cells, triggering an autoimmune response against the joints. The interaction between HLA-DRB1 and citrullinated peptides is a key event in the pathogenesis of RA.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is incorrect because HLA-DRB1 is the correct association with rheumatoid arthritis, not HLA-A or HLA-B.
* **Option B:** HLA-B27 is associated with ankylosing spondylitis, a different autoimmune disease, not rheumatoid arthritis.
* **Option C:** HLA-DQ8 is associated with type 1 diabetes, another autoimmune disease, but not rheumatoid arthritis.
* **Option D:** This option is incorrect because HLA-DQ2 is associated with celiac disease, a different autoimmune disease, not rheumatoid arthritis.
**Clinical Pearl / High-Yield Fact**
Remember that the HLA-DRB1 shared epitope alleles are a strong risk factor for developing rheumatoid arthritis, particularly in individuals with a family history of the disease.
**Correct Answer: D. HLA-DRB1**