Intercellular adhesion molecule 1 (ICAM-1) gene polymorphisms in Italian patients with rheumatoid arthritis

Aims Rheumatoid arthritis (AA) has a wide range of clinical expressions which pr obably reflects different generic backgrounds. Intercellular adhesion molec ule-1 (ICAM-1) plays an important role in the inflammatory synovial activit y in RA. The aim of this study was to examine the potential associations of ICAM-1 gene polymorphisms with RA and its severity. Methods Seventy-eight seropositive Italian RA patients with erosive disease entered the study. Radiographs of hands and feet 5 years after the diagnosis were available for 68 patients and were evaluated for the number of eroded joint s. We obtained an erosive score for each patient by counting the number of joints with at least one erosion. Patients in the upper part of the distrib ution over the median were considered as fast eroders (FE) and the others a s slow eroders (SE). Patients' records were also evaluated for the presence of extra-articular features. 228 healthy subjects of the same ethnic origi n were selected as a control group. All of the RA patients and controls wer e genotyped by polymer ase chain reaction and allele-specific oligonucleoti de techniques for ICAM-1 polymorphisms G/R at codon 241 (exon 4) and E/K at codon 469 (exon 6). Results The carriage I ate of allele R241 was significantly higher in RA patients t han in healthy controls (12.8% versus 5.7%, p = 0.039; odds ratio: 2.4 [95% CI 1.02 to 5.79]). The allele frequencies and carriage rate of the E 469 g ene did not differ significantly between RA patients and the control group. Wizen we compared the control group with the patients with move or less se vere disease (presence or absence of extra-articular features SE and FE) we found that only the group of patients with the more favourable course main tained a significant difference in the carriage rate of R241 (16.7 vs 5.7%, p = 0.009 for patients without extra-articular features and 18.9 vs 5.7%, p = 0.004 for SE patients). Conclusion Our preliminary findings show that C/R 241 polymorphism of ICAM-1 is associ ated with RA, and that this confers a reduced risk of extra-articular manif estations and is associated with a slow rate of joint destruction.