Ek Weronica E, D'Amato Mauro, Halfvarson Jonas
Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm (Weronica E. Ek, Mauro D'Amato), Sweden.
Department of Internal medicine, Division of Gastroenterology, Örebro University Hospital and School of Health and Medical Sciences, Örebro University, Örebro (Jonas Halfvarson), Sweden.
Ann Gastroenterol. 2014;27(4):294-303.
The influence of genetics in the etiology of inflammatory bowel disease (IBD) was initially demonstrated by epidemiological data, including differences in prevalence among different ethnic groups, familial aggregation of IBD, concordance in twins, and association with genetic syndromes. These early observations paved the way to molecular genetics in IBD, and culminated in the identification of nucleotide-binding oligomerization domain containing 2 (NOD2) gene as an IBD risk gene in 2001. As in other complex diseases, the advent of Genome Wide Association studies has dramatically improved the resolution of the IBD genome and our understanding of the pathogenesis of IBD. However, the complexity of the genetic puzzle in IBD seems more pronounced today than ever previously. In total, 163 risk genes/loci have been identified, and the corresponding number of possible causal variants is challenging. The great majority of these loci are associated with both Crohn's disease and ulcerative colitis, suggesting that nearly all of the biological mechanisms involved in one disease play some role in the other. Interestingly, a large proportion of the IBD risk loci are also shared with other immune-mediated diseases, primary immunodeficiencies and mycobacterial diseases.
遗传学在炎症性肠病(IBD)病因学中的影响最初是由流行病学数据证明的,这些数据包括不同种族群体中患病率的差异、IBD的家族聚集性、双胞胎的一致性以及与遗传综合征的关联。这些早期观察为IBD的分子遗传学研究铺平了道路,并在2001年最终确定核苷酸结合寡聚化结构域包含2(NOD2)基因是一种IBD风险基因。与其他复杂疾病一样,全基因组关联研究的出现极大地提高了IBD基因组的分辨率以及我们对IBD发病机制的理解。然而,如今IBD遗传难题的复杂性似乎比以往任何时候都更加明显。总共已鉴定出163个风险基因/位点,相应的可能致病变异数量极具挑战性。这些位点中的绝大多数与克罗恩病和溃疡性结肠炎都相关,这表明几乎所有涉及一种疾病的生物学机制在另一种疾病中也发挥着某种作用。有趣的是,很大一部分IBD风险位点也与其他免疫介导疾病、原发性免疫缺陷和分枝杆菌病共有。
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