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Background  Several studies point to a role of Toll-like receptors (TLRs) in the development of rheumatoid arthritis (RA). We investigated if genetic variants in  TLR  genes are associated with RA and response to tumour necrosis factor blocking (anti-TNF) medication.    Methodology and Principal Findings  22 single nucleotide polymorphisms (SNPs) in seven  TLR  genes were genotyped in a Dutch cohort consisting of 378 RA patients and 294 controls. Significantly associated variants were investigated in replication cohorts from The Netherlands, United Kingdom and Sweden (2877 RA patients and 2025 controls). 182 of the Dutch patients were treated with anti-TNF medication. Using these patients and a replication cohort (269 Swedish patients) we analysed if genetic variants in  TLR  genes were associated with anti-TNF outcome. In the discovery phase of the study we found a significant association of SNPs rs2072493 in  TLR5  and rs3853839 in  TLR7  with RA disease susceptibility. Meta-analysis of discovery and replication cohorts did not confirm these findings. SNP rs2072493 in  TLR5  was associated with anti-TNF outcome in the Dutch but not in the Swedish population.    Conclusion  We conclude that genetic variants in  TLRs  do not play a major role in susceptibility for developing RA nor in anti-TNF treatment outcome in a Caucasian population.

Genetic Variants in Toll-Like Receptors Are Not Associated with Rheumatoid Arthritis Susceptibility or Anti-Tumour Necrosis Factor Treatment Outcome