Duerr Richard H
Inflammatory Bowel Disease Genetics Laboratory, Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA.
Gastroenterol Clin North Am. 2002 Mar;31(1):63-76. doi: 10.1016/s0889-8553(01)00005-x.
The complex genetics of IBD is characterized by more than one susceptibility locus, genetic heterogeneity, incomplete penetrance, and probable gene-gene and gene-environment interactions. Functional candidate gene association studies during the past few decades have revealed only modest associations between IBD and genetic variants in the HLA genes and a limited number of other genes that are involved in immune regulation and the inflammatory response. Important advances in IBD genetics research have come about from systematic genome searches for IBD loci. The identification of Crohn's disease-associated NOD2 genetic variants that appear to alter the innate immune response to bacteria is a seminal finding that perhaps is the greatest advance toward understanding the pathogenesis of IBD in decades. The future discovery of other IBD genetic risk factors, facilitated by the completion of the human genome sequencing and annotation, may allow the development of better therapies, possibly including preventive therapies, for patients with Crohn's disease and ulcerative colitis.
炎症性肠病复杂的遗传学特征表现为存在不止一个易感基因座、遗传异质性、不完全外显率以及可能的基因-基因和基因-环境相互作用。在过去几十年中,功能性候选基因关联研究仅揭示了炎症性肠病与HLA基因以及有限数量的其他参与免疫调节和炎症反应的基因中的遗传变异之间存在适度关联。炎症性肠病遗传学研究的重要进展来自于对炎症性肠病基因座的系统性全基因组搜索。与克罗恩病相关的NOD2基因变异的鉴定似乎改变了对细菌的固有免疫反应,这是一项具有开创性的发现,可能是数十年来在理解炎症性肠病发病机制方面取得的最大进展。随着人类基因组测序和注释工作的完成,未来对其他炎症性肠病遗传风险因素的发现,可能会为克罗恩病和溃疡性结肠炎患者开发出更好的治疗方法,甚至可能包括预防性治疗。
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