Lakatos Peter Laszlo, Fischer Simon, Claes Karolien, Kovacs Agota, Molnar Tamas, Altorjay Istvan, Demeter Pal, Tulassay Zsolt, Palatka Karoly, Papp Maria, Rutgeerts Paul, Szalay Ferenc, Papp Janos, Vermeire Severine, Lakatos Laszlo
First Department of Medicine, Semmelweis University, Budapest, Hungary.
Inflamm Bowel Dis. 2006 May;12(5):362-8. doi: 10.1097/01.MIB.0000217336.38312.09.
Recent data suggest that haplotypic variants of the DLG5 gene on 10q23 are associated with susceptibility to inflammatory bowel disease (IBD) in Germany. In view of the geographical differences in frequency of genetic markers and the absence of data in Central European patients, our aim was to determine the DLG5 R30Q variant in Hungarian IBD patients.
We investigated 773 unrelated IBD patients (age 38.1 +/- 10.3 years; duration, 8.8 +/- 7.5 years; Crohn's disease [CD]: 639; male/female, 309/330; duration, 8.4 +/- 7.1 years; ulcerative colitis [UC]: 134; male/female, 63/71; duration, 10.6 +/- 8.9 years) and 150 healthy subjects. DLG5 R30Q and TLR4 D299G variants were tested by polymerase chain reaction/restriction fragment length polymorphism. DNA was screened for NOD2/CARD15 mutations by denaturing high-performance liquid chromatography. Detailed clinical phenotype was determined by reviewing the medical charts.
The frequency of the R30Q variant allele was not significantly different in IBD (22.0%), CD (20.8%), and UC (27.6%) patients compared with healthy control subjects (28.0%). In CD, the 113A variant allele was associated with steroid resistance (16.3% vs noncarriers, 7.6%; odds ratio [OR], 2.4; 95% CI 1.3-4.5; P = 0.013). In a logistic regression model carriage of DLG5 R30Q, perianal involvement and frequent relapses were independently associated with steroid resistance. No phenotype-genotype associations were found in UC patients, although a trend toward more extensive disease was observed in carriers of the variant allele (OR = 2.1; 95% CI 0.95-4.4; P = 0.07).
The present data strongly contrast previous data from Germany. DLG5 113A is not associated with disease susceptibility, but there was a tendency for this allele to confer resistance to steroids. Further studies are required to evaluate the significance of DLG5 in other populations from geographically diverse regions.
近期数据表明,10q23上DLG5基因的单倍型变异与德国炎症性肠病(IBD)的易感性相关。鉴于遗传标记频率存在地域差异且中欧患者缺乏相关数据,我们的目的是确定匈牙利IBD患者中DLG5 R30Q变异情况。
我们调查了773例无亲缘关系的IBD患者(年龄38.1±10.3岁;病程8.8±7.5年;克罗恩病[CD]:639例;男性/女性,309/330例;病程8.4±7.1年;溃疡性结肠炎[UC]:134例;男性/女性,63/71例;病程10.6±8.9年)以及150名健康受试者。通过聚合酶链反应/限制性片段长度多态性检测DLG5 R30Q和TLR4 D299G变异。通过变性高效液相色谱法筛查DNA中的NOD2/CARD15突变。通过查阅病历确定详细的临床表型。
与健康对照受试者(28.0%)相比,IBD患者(22.0%)、CD患者(20.8%)和UC患者(27.6%)中R30Q变异等位基因的频率无显著差异。在CD中,113A变异等位基因与类固醇抵抗相关(16.3%对非携带者,7.6%;优势比[OR],2.4;95%置信区间1.3 - 4.5;P = 0.013)。在逻辑回归模型中,DLG5 R30Q携带、肛周受累和频繁复发与类固醇抵抗独立相关。UC患者中未发现表型 - 基因型关联,尽管在变异等位基因携带者中观察到疾病更广泛的趋势(OR = 2.1;95%置信区间0.95 - 4.4;P = 0.07)。
目前的数据与德国先前的数据形成强烈对比。DLG5 113A与疾病易感性无关,但该等位基因有赋予类固醇抵抗的趋势。需要进一步研究以评估DLG5在来自不同地理区域的其他人群中的意义。