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Bank S, Andersen PS, Burisch J, Pedersen N, Roug S, Galsgaard J, Ydegaard Turino S, Broder Brodersen J, Rashid S, Kaiser Rasmussen B, Avlund S, Bastholm Olesen T, Hoffmann HJ, Andersen Nexø B, Sode J, Vogel U, Andersen V. Polymorphisms in the Toll-Like Receptor and the IL-23/IL-17 Pathways Were Associated with Susceptibility to Inflammatory Bowel Disease in a Danish Cohort. PLoS One 2015; 10:e0145302. [PMID: 26698117 PMCID: PMC4689491 DOI: 10.1371/journal.pone.0145302] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 12/02/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The inflammatory bowel diseases (IBD), Crohn's disease (CD) and ulcerative colitis (UC), result from the combined effects of susceptibility genes and environmental factors. Previous studies have shown that polymorphisms in the Toll-like receptor (TLR), the apoptosis, the IL-23/IL-17 and the interferon gamma (IFNG) pathways are associated with risk of both CD and UC. METHODS Using a candidate gene approach, 21 functional single nucleotide polymorphisms (SNPs) in 15 genes were assessed in a clinical homogeneous group of severely diseased ethnic Danish patients consisting of 624 patients with CD, 411 patients with UC and 795 controls. The results were analysed using logistic regression. RESULTS The polymorphisms TLR5 (rs5744174) and IL12B (rs6887695) were associated with risk of CD, and TLR1 (rs4833095) and IL18 (rs187238) were associated with risk of both CD and UC (p<0.05). After Bonferroni correction for multiple testing, the homozygous variant genotype of TLR1 743 T>C (rs4833095) was associated with increased risk CD (OR: 3.15, 95% CI: 1.59-6.26, p = 0.02) and CD and UC combined (OR: 2.96, 95% CI: 1.64-5.32, p = 0.005). CONCLUSION Our results suggest that genetically determined high activity of TLR1 and TLR5 was associated with increased risk of both CD and UC and CD, respectively. This supports that the host microbial composition or environmental factors in the gut are involved in risk of IBD. Furthermore, genetically determined high activity of the IL-23/IL-17 pathway was associated with increased risk of CD and UC. Overall, our results support that genetically determined high inflammatory response was associated with increased risk of both CD and UC.
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Affiliation(s)
- Steffen Bank
- Medical Department, Viborg Regional Hospital, Viborg, Denmark
- Biomedicine, University of Aarhus, Aarhus, Denmark
- * E-mail:
| | - Paal Skytt Andersen
- Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark
- Veterinary Disease Biology, University of Copenhagen, Copenhagen, Denmark
| | - Johan Burisch
- Department of Gastroenterology, Herlev Hospital, Herlev, Denmark
| | - Natalia Pedersen
- Department of Gastroenterology, Herlev Hospital, Herlev, Denmark
| | - Stine Roug
- Department of Gastroenterology, Hvidovre Hospital, Hvidovre, Denmark
| | | | | | - Jacob Broder Brodersen
- Medical Department, Sydvestjysk Hospital, Esbjerg, Denmark
- Department of medical Gastroenterology, Odense University Hospital, Odense, Denmark
| | - Shaista Rashid
- Medical Department, Bispebjerg Hospital, Bispebjerg, Denmark
| | | | - Sara Avlund
- Medical Department V, Aarhus University Hospital, Aarhus, Denmark
| | | | - Hans Jürgen Hoffmann
- Department of Respiratory Diseases B, Institute for Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | | | - Jacob Sode
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Department of Autoimmunology and Biomarkers, Statens Serum Institut, Copenhagen, Denmark
- Department of Rheumatology, Frederiksberg Hospital, Frederiksberg, Denmark
| | - Ulla Vogel
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Vibeke Andersen
- Medical Department, Viborg Regional Hospital, Viborg, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Research unit for Molecular Diagnostic, Hospital of Southern Jutland Aabenraa, Aabenraa, Denmark
- OPEN Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark
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Bank S, Andersen PS, Burisch J, Pedersen N, Roug S, Galsgaard J, Turino SY, Brodersen JB, Rashid S, Rasmussen BK, Avlund S, Olesen TB, Hoffmann HJ, Thomsen MK, Thomsen VØ, Frydenberg M, Nexø BA, Sode J, Vogel U, Andersen V. Associations between functional polymorphisms in the NFκB signaling pathway and response to anti-TNF treatment in Danish patients with inflammatory bowel disease. Pharmacogenomics J 2014; 14:526-34. [PMID: 24776844 DOI: 10.1038/tpj.2014.19] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Revised: 03/01/2014] [Accepted: 03/10/2014] [Indexed: 12/30/2022]
Abstract
Antitumor necrosis factor-α (TNF-α) is used for treatment of severe cases of inflammatory bowel diseases (IBD), including Crohn's disease (CD) and ulcerative colitis (UC). However, one-third of the patients do not respond to the treatment. Genetic markers may predict individual response to anti-TNF therapy. Using a candidate gene approach, 39 mainly functional single nucleotide polymorphisms (SNPs) in 26 genes regulating inflammation were assessed in 738 prior anti-TNF-naive Danish patients with IBD. The results were analyzed using logistic regression (crude and adjusted for age, gender and smoking status). Nineteen functional polymorphisms that alter the NFκB-mediated inflammatory response (TLR2 (rs3804099, rs11938228, rs1816702, rs4696480), TLR4 (rs5030728, rs1554973), TLR9 (rs187084, rs352139), LY96 (MD-2) (rs11465996), CD14 (rs2569190), MAP3K14 (NIK) (rs7222094)), TNF-α signaling (TNFA (TNF-α) (rs361525), TNFRSF1A (TNFR1) (rs4149570), TNFAIP3(A20) (rs6927172)) and other cytokines regulated by NFκB (IL1B (rs4848306), IL1RN (rs4251961), IL6 (rs10499563), IL17A (rs2275913), IFNG (rs2430561)) were associated with response to anti-TNF therapy among patients with CD, UC or both CD and UC (P ⩽ 0.05). In conclusion, the results suggest that polymorphisms in genes involved in activating NFκB through the Toll-like receptor (TLR) pathways, genes regulating TNF-α signaling and cytokines regulated by NFκB are important predictors for the response to anti-TNF therapy among patients with IBD. Genetically strong TNF-mediated inflammatory response was associated with beneficial response. In addition, the cytokines IL-1β, IL-6 and IFN-γ may be potential targets for treating patients with IBD who do not respond to anti-TNF therapy. These findings should be examined in independent cohorts before these results are applied in a clinical setting.
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Affiliation(s)
- S Bank
- 1] Medical Department, Viborg Regional Hospital, Viborg, Denmark [2] Biomedicine, University of Aarhus, Aarhus, Denmark
| | - P S Andersen
- Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark
| | - J Burisch
- Department of Gastroenterology, Herlev Hospital, Herlev, Denmark
| | - N Pedersen
- Department of Gastroenterology, Herlev Hospital, Herlev, Denmark
| | - S Roug
- Department of Gastroenterology, Hvidovre Hospital, Hvidovre, Denmark
| | - J Galsgaard
- Medical Department, Køge Hospital, Køge, Denmark
| | - S Y Turino
- Medical Department, Hillerød Hospital, Hillerød, Denmark
| | - J B Brodersen
- Medical Department, Sydvestjysk Hospital, Esbjerg, Denmark
| | - S Rashid
- Medical Department, Bispebjerg Hospital, Bispebjerg, Denmark
| | - B K Rasmussen
- Medical Department, Nykøbing Falster Hospital, Nykøbing Falster, Denmark
| | - S Avlund
- Medical Department V, Aarhus University Hospital, Aarhus, Denmark
| | - T B Olesen
- Medical Department, Slagelse Hospital, Slagelse, Denmark
| | - H J Hoffmann
- Department of Respiratory Diseases B, Institute for Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - M K Thomsen
- Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark
| | - V Ø Thomsen
- International Reference Laboratory of Mycobacteriology, Statens Serum Institut, Copenhagen, Denmark
| | - M Frydenberg
- Section of Biostatistics, Department of Public health, Aarhus University, Aarhus, Denmark
| | - B A Nexø
- Biomedicine, University of Aarhus, Aarhus, Denmark
| | - J Sode
- 1] Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark [2] Clinical Biochemistry, Immunology & Genetics, Statens Serum Institut, Copenhagen, Denmark [3] Department of Rheumatology, Frederiksberg Hospital, Frederiksberg, Denmark
| | - U Vogel
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - V Andersen
- 1] Medical Department, Viborg Regional Hospital, Viborg, Denmark [2] Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark [3] Organ Centre, Hospital of Southern Jutland Aabenraa, Aabenraa, Denmark [4] OPEN Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark
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