HLA-DR molecules can be altered genetically in such a sense to lead to the pathway of the so called “Cinderella Slipper” coined by the work of researchers Peter K. Gregerson of the Feinstein Institute of Medical Research, Lars Klareskog of the Karolinska Institute, and Robert J. Winchester of Columbia University. They have discovered that having one HLA risk gene coupled with being a smoker will quintuple the risk of developing the autoimmune disease, Rheumatoid Arthritis — so called the “Foot” that fits into the Cinderella Slipper. Having two HLA risk genes together with being a smoker makes that risk ten times higher in developing Rheumatoid Arthritis when compared to having one risk gene.
For their work, these three researchers have been awarded the 2013 Crafoord prize in polyarthritis research. Watch the video here:
This means that particularly for middle-income countries with high and rising rates of smoking, high population, and high rates of aging, Rheumatoid Arthritis will pose a truly serious problem in the coming future unless preventative mechanisms will come into play concerning smoking, i.e. education campaigns, warning labels, and increased taxation.