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      Polymorphisms in the Inflammatory Pathway Genes TLR2, TLR4, TLR9, LY96, NFKBIA, NFKB1, TNFA, TNFRSF1A, IL6R, IL10, IL23R, PTPN22, and PPARG Are Associated with Susceptibility of Inflammatory Bowel Disease in a Danish Cohort

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          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. Polymorphisms in genes regulating inflammation may explain part of the genetic heritage.

          Methods

          Using a candidate gene approach, 39 mainly functional single nucleotide polymorphisms (SNPs) in 26 genes regulating inflammation were assessed in a clinical homogeneous group of severely diseased patients consisting of 624 patients with CD, 411 patients with UC and 795 controls. The results were analysed using logistic regression.

          Results

          Sixteen polymorphisms in 13 genes involved in regulation of inflammation were associated with risk of CD and/or UC (p≤0.05). The polymorphisms TLR2 (rs1816702), NFKB1 (rs28362491), TNFRSF1A (rs4149570), IL6R (rs4537545), IL23R (rs11209026) and PTPN22 (rs2476601) were associated with risk of CD and the polymorphisms TLR2 (rs1816702), TLR4 (rs1554973 and rs12377632), TLR9 (rs352139), LY96 (rs11465996), NFKBIA (rs696), TNFA (rs1800629), TNFRSF1A (rs4149570), IL10 (rs3024505), IL23R (rs11209026), PTPN22 (rs2476601) and PPARG (rs1801282) were associated with risk of UC. When including all patients (IBD) the polymorphisms TLR2 (rs4696480 and rs1816702), TLR4 (rs1554973 and rs12377632), TLR9 (rs187084), TNFRSF1A (rs4149570), IL6R (rs4537545), IL10 (rs3024505), IL23R (rs11209026) and PTPN22 (rs2476601) were associated with risk. After Bonferroni correction for multiple testing, both the homozygous and the heterozygous variant genotypes of IL23R G>A(rs11209026) (OR CD,adj: 0.38, 95% CI: 0.21–0.67, p = 0.03; OR IBD,adj 0.43, 95% CI: 0.28–0.67, p = 0.007) and PTPN22 1858 G>A(rs2476601) (OR CD,unadj 0.54, 95% CI: 0.41–0.72, p = 7*10 −4; OR IBD,unadj: 0.61, 95% CI: 0.48–0.77, p = 0.001) were associated with reduced risk of CD.

          Conclusion

          The biological effects of the studied polymorphisms suggest that genetically determined high inflammatory response was associated with increased risk of CD. The many SNPs found in TLRs suggest that the host microbial composition or environmental factors in the gut are involved in risk of IBD in genetically susceptible individuals.

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          Most cited references60

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          Sequence variants in IL10, ARPC2 and multiple other loci contribute to ulcerative colitis susceptibility.

          Inflammatory bowel disease (IBD) typically manifests as either ulcerative colitis (UC) or Crohn's disease (CD). Systematic identification of susceptibility genes for IBD has thus far focused mainly on CD, and little is known about the genetic architecture of UC. Here we report a genome-wide association study with 440,794 SNPs genotyped in 1,167 individuals with UC and 777 healthy controls. Twenty of the most significantly associated SNPs were tested for replication in three independent European case-control panels comprising a total of 1,855 individuals with UC and 3,091 controls. Among the four consistently replicated markers, SNP rs3024505 immediately flanking the IL10 (interleukin 10) gene on chromosome 1q32.1 showed the most significant association in the combined verification samples (P = 1.35 x 10(-12); OR = 1.46 (1.31-1.62)). The other markers were located in ARPC2 and in the HLA-BTNL2 region. Association between rs3024505 and CD (1,848 cases, 1,804 controls) was weak (P = 0.013; OR = 1.17 (1.01-1.34)). IL10 is an immunosuppressive cytokine that has long been proposed to influence IBD pathophysiology. Our findings strongly suggest that defective IL10 function is central to the pathogenesis of the UC subtype of IBD.
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            TLR-4, IL-1R and TNF-R signaling to NF-kappaB: variations on a common theme.

            Toll-like receptors (TLRs) as well as the receptors for tumor necrosis factor (TNF-R) and interleukin-1 (IL-1R) play an important role in innate immunity by regulating the activity of distinct transcription factors such as nuclear factor-kappaB (NF-kappaB). TLR, IL-1R and TNF-R signaling to NF-kappaB converge on a common IkappaB kinase complex that phosphorylates the NF-kappaB inhibitory protein IkappaBalpha. However, upstream signaling components are in large part receptor-specific. Nevertheless, the principles of signaling are similar, involving the recruitment of specific adaptor proteins and the activation of kinase cascades in which protein-protein interactions are controlled by poly-ubiquitination. In this review, we will discuss our current knowledge of NF-kappaB signaling in response to TLR-4, TNF-R and IL-1R stimulation, with a special focus on the similarities and dissimilarities among these pathways.
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              Inflammatory Bowel Disease

              Inflammatory bowel disease (IBD) is the term used for a group of diseases with yet unknown etiology, prevalence of which is increasing almost everywhere in the world. The disease was almost non-existent four decades ago in the east, including the middle-east, while now a days it is seen more and more. In addition to the increasing prevalence, our knowledge about its pathogenesis, clinical course, diagnosis, and treatment has changed dramatically over the past couple of decades. This has changed our concept of this group of diseases, their diagnosis, treatment, and treatment goals. Considering the vast literature on the subject, it is timely to review major topics in IBD with a look on the regional progress and knowledge as well. This essay is aimed to cover this task.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2014
                27 June 2014
                : 9
                : 6
                : e98815
                Affiliations
                [1 ]Medical Department, Viborg Regional Hospital, Viborg, Denmark
                [2 ]Biomedicine, University of Aarhus, Aarhus, Denmark
                [3 ]Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark
                [4 ]Department of Gastroenterology, Herlev Hospital, Herlev, Denmark
                [5 ]Department of Gastroenterology, Hvidovre Hospital, Hvidovre, Denmark
                [6 ]Medical Department, Køge Hospital, Køge, Denmark
                [7 ]Medical Department, Hillerød Hospital, Hillerød, Denmark
                [8 ]Medical Department, Sydvestjysk Hospital, Esbjerg, Denmark
                [9 ]Medical Department, Bispebjerg Hospital, Bispebjerg, Denmark
                [10 ]Medical Department, Nykøbing Falster Hospital, Nykøbing Falster, Denmark
                [11 ]Medical Department V, Aarhus University Hospital, Aarhus, Denmark
                [12 ]Medical Department, Slagelse Hospital, Slagelse, Denmark
                [13 ]Department of Respiratory Diseases B, Institute for Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
                [14 ]Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark
                [15 ]International Reference Laboratory of Mycobacteriology, Statens Serum Institut, Copenhagen, Denmark
                [16 ]Section of Biostatistics, Department of Public health, Aarhus University, Aarhus, Denmark
                [17 ]Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
                [18 ]Clinical Biochemistry, Immunology & Genetics, Statens Serum Institut, Copenhagen, Denmark
                [19 ]Department of Rheumatology, Frederiksberg Hospital, Frederiksberg, Denmark
                [20 ]National Research Centre for the Working Environment, Copenhagen, Denmark
                [21 ]Organ Centre, Hospital of Southern Jutland Aabenraa, Aabenraa, Denmark
                [22 ]OPEN Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark
                Charité, Campus Benjamin Franklin, Germany
                Author notes

                Competing Interests: PSA, VØT and JS have affiliation to Statens Serum Institut. Statens Serum Institut is not a commercial company. It is a public enterprise under the Danish Ministry of Health (please see http://www.ssi.dk/English/Service/AboutSSI.aspx). This does not alter the authors' adherence to PLOS ONE policies on sharing data and materials.

                Conceived and designed the experiments: SB PSA MF BAN JS UV VA. Performed the experiments: SB JB NP S. Roug JG SYT JBB S. Rashid BKR SA TBO HJH MKT VØT. Analyzed the data: SB PSA MF BAN JS UV VA. Contributed reagents/materials/analysis tools: SB JB NP S. Roug JG SYT JBB S. Rashid BKR SA TBO HJH MKT VØT MF. Wrote the paper: SB PSA UV VA. Drafting the article or revising it critically: SB PSA JB NP S. Roug JG SYT JBB S. Rashid BKR SA TBO HJH MKT VØT MF BAN JS UV VA. Final approval of the version to be published: SB PSA JB NP S. Roug JG SYT JBB S. Rashid BKR SA TBO HJH MKT VØT MF BAN JS UV VA.

                Article
                PONE-D-14-09659
                10.1371/journal.pone.0098815
                4074037
                24971461
                382243a8-e0f4-4c5b-80c9-0bb020d6e90c
                Copyright @ 2014

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 4 March 2014
                : 7 May 2014
                Page count
                Pages: 10
                Funding
                The work was funded by Health Research Fund of Central Denmark Region, Colitis-Crohn Foreningen and University of Aarhus (PhD grant). VA receives compensation as a consultant for Merck & Co., Inc. (MSD) and Janssen. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Biology and Life Sciences
                Evolutionary Biology
                Population Genetics
                Genetic Polymorphism
                Immunology
                Clinical Immunology
                Autoimmune Diseases
                Crohn's Disease
                Molecular Biology
                Molecular Biology Techniques
                Artificial Gene Amplification and Extension
                Polymerase Chain Reaction
                Medicine and Health Sciences
                Clinical Medicine
                Gastroenterology and Hepatology
                Inflammatory Bowel Disease
                Colitis
                Ulcerative Colitis
                Research and Analysis Methods
                Research Design
                Case-Control Studies

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                Uncategorized

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