• Ivanka Marinović, Esma Čečuk-Jeličić, Dijana Perković, Marasović KrstulovićDanielaDDepartment of Rheumatology and Clinical Immunology, University Hospital of Split, Spinčićeva 1, 21000, Split, Croatia.University of Split School of Medicine, Šoltanska 2, 21000, Split, Croatia., Jure Aljinović, Daniela Šošo, Ela Škorić, and Martinović KaliternaDušankaDDepartment of Rheumatology and Clinical Immunology, University Hospital of Split, Spinčićeva 1, 21000, Split, Croatia.University of Split School of Medicine, Šoltanska 2, 21000, Split, Croatia..
• Department of Physical Medicine and Rehabilitation with Rheumatology, University Hospital of Split, Spinčićeva 1, 21000, Split, Croatia. imarinovic27@gmail.com.
• Wien. Klin. Wochenschr. 2022 Jun 1; 134 (11-12): 463-470.

ObjectiveThe aim of this study was to investigate the distribution of HLA-DRB1 alleles in patients with rheumatoid arthritis (RA) in the Sinj Region (SR) and the rest of the Split-Dalmatia County (SDC) in Croatia and to determine their relationship with disease severity.MethodsA total of 74 RA patients and 80 healthy controls from the SR, and 74 RA patients and 80 healthy controls from the rest of the SDC were genotyped using sequence-specific oligonucleotide primed PCR. High-resolution typing of HLA-DRB1*04 alleles was performed using the single specific primed polymerase chain reaction (PCR-SSP) method. Serum anti-CCP, rheumatoid factor, C‑reactive protein, and erythrocyte sedimentation rate were measured in all RA patients, whereas disease activity was assessed by DAS-28 and functional status by the Health Assessment Questionnaire Disability Index.ResultsThe HLA-DRB1*04 allele was more frequent in patients with RA from the SR than that in patients from the rest of the SDC (18.2% vs. 9.5%; P = 0.014), whereas the HLA-DRB1*15 allele was more frequent in patients with RA from the rest of the SDC than in patients from the SR (16.2% vs. 7.4%; P = 0.010). Shared epitope (SE) positive patients from the SR had significantly higher serum anti-CCP and RF antibody levels (P = 0.014 and P = 0.004, respectively), higher disease activity (P = 0.043), and worse functional status (P < 0.001), than SE-positive patients from the rest of the SDC.ConclusionThe observed higher incidence of more severe forms of RA in the SR in comparison to the rest of the SDC might be associated with the higher incidence of HLA-DRB1*04 allele in the SR.© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.

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