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      Las mutaciones del gen CARD15 presentan escasa relación con los fenotipos de la enfermedad de Crohn en Asturias Translated title: CARD15 mutations are poorly related to Crohn´s disease phenotypes in Asturias

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          Abstract

          Introducción: la asociación entre las mutaciones del gen CARD15 y la susceptibilidad genética para la enfermedad de Crohn (EC) se ha confirmado en diversos estudios, con amplias variaciones observadas a nivel mundial, tanto geográficas como étnicas. Objetivos: analizar la prevalencia de gen CARD 15 y sus polimorfismos en pacientes con EC en Asturias y su posible correlación con los diversos fenotipos de la enfermedad. Métodos: estudiamos la frecuencia de las tres mutaciones del gen CARD15 (R702W, G908R, L1007fs) usando cebadores específicos, en un total de 216 pacientes con EC y 86 controles procedentes del área de Oviedo. Los pacientes fueron clasificados de acuerdo con la edad al diagnóstico, localización la enfermedad y su comportamiento clínico (clasificación de Viena). Resultados: la frecuencia global de portadores de las mutaciones del gen CARD15 en los pacientes con EC fue del 17,3% frente a un 17,6% en controles (NS). Al analizar separadamente los polimorfismos R702, G908R y L1007fs los pacientes mostraban frecuencias del 8,8, 3 y 6% respectivamente, mientras que los controles las presentaban en el 11,6, 2,3 y 3,5%, sin encontrar diferencias significativas para ninguna de ellas (NS). Las frecuencias observadas en controles, fueron similares a las encontradas en otras regiones españolas. Conclusiones: la prevalencia de mutaciones en CARD15 en pacientes con EC en Asturias es menor a la reportada en otros trabajos publicados en población española. Otros factores ambientales, además de los genéticos, parecen tener mayor importancia en el desarrollo de EC en nuestra área.

          Translated abstract

          Background: the association between the three common CARD15 gene mutations (R702W, G908R, L1007fs) and the genetic susceptibility to Crohn's disease (CD) have been confirmed by several studies, with some differences found, in relation to geographic areas and ethnic groups. Objectives: To analyze the prevalence of CARD15 gen and its polymorphisms in patients with CD in Asturias and its possible correlation with the different genotypes of the disease. Methods: a total of 216 CD patients recruited from Asturias (North of Spain) and 86 ethnically matched healthy controls, were typed using Hybprobes on a LightCycler instrument for CARD15 mutations. Patients were subdivided according to Vienna classification. We have studied the frequency of these mutations in the different subgroups of CD patients and analyzed its contribution to the disease clinical characteristics and progression. Results: carrier frequencies for CARD15 mutations in our CD patients were similar to controls (17.8 vs. 17.4%) respectively (NS). CD patients exhibited frequencies of 8.8, 3.0 and 6.0% for the R702, G908R and L1007fs polymorphisms respectively, whereas our control population had allele frequencies of 11.6, 2.3 and 3.5% for the three mutations respectively (NS). We did not find any relationship between CARD15 mutations and the different phenotypes of Crohn's disease, according to Vienna classification. Conclusions: in our CD population, other factors (i.e. environmental), in addition to genetics, must be mainly involved in the development of the disease.

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          Association of NOD2 leucine-rich repeat variants with susceptibility to Crohn's disease.

          Crohn's disease and ulcerative colitis, the two main types of chronic inflammatory bowel disease, are multifactorial conditions of unknown aetiology. A susceptibility locus for Crohn's disease has been mapped to chromosome 16. Here we have used a positional-cloning strategy, based on linkage analysis followed by linkage disequilibrium mapping, to identify three independent associations for Crohn's disease: a frameshift variant and two missense variants of NOD2, encoding a member of the Apaf-1/Ced-4 superfamily of apoptosis regulators that is expressed in monocytes. These NOD2 variants alter the structure of either the leucine-rich repeat domain of the protein or the adjacent region. NOD2 activates nuclear factor NF-kB; this activating function is regulated by the carboxy-terminal leucine-rich repeat domain, which has an inhibitory role and also acts as an intracellular receptor for components of microbial pathogens. These observations suggest that the NOD2 gene product confers susceptibility to Crohn's disease by altering the recognition of these components and/or by over-activating NF-kB in monocytes, thus documenting a molecular model for the pathogenic mechanism of Crohn's disease that can now be further investigated.
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            Host recognition of bacterial muramyl dipeptide mediated through NOD2. Implications for Crohn's disease.

            NOD2, a protein associated with susceptibility to Crohn's disease, confers responsiveness to bacterial preparations of lipopolysaccharide and peptidoglycan, but the precise moiety recognized remains elusive. Biochemical and functional analyses identified muramyl dipeptide (MurNAc-L-Ala-D-isoGln) derived from peptidoglycan as the essential structure in bacteria recognized by NOD2. Replacement of L-Ala for D-Ala or D-isoGln for L-isoGln eliminated the ability of muramyl dipeptide to stimulate NOD2, indicating stereoselective recognition. Muramyl dipeptide was recognized by NOD2 but not by TLR2 or co-expression of TLR2 with TLR1 or TLR6. NOD2 mutants associated with susceptibility to Crohn's disease were deficient in their recognition of muramyl dipeptide. Notably, peripheral blood mononuclear cells from individuals homozygous for the major disease-associated L1007fsinsC NOD2 mutation responded to lipopolysaccharide but not to synthetic muramyl dipeptide. Thus, NOD2 mediates the host response to bacterial muropeptides derived from peptidoglycan, an activity that is important for protection against Crohn's disease. Because muramyl dipeptide is the essential structure of peptidoglycan required for adjuvant activity, these results also have implications for understanding adjuvant function and effective vaccine development.
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              CARD15/NOD2 mutational analysis and genotype-phenotype correlation in 612 patients with inflammatory bowel disease.

              CARD15/NOD2 encodes a protein involved in bacterial recognition by monocytes. Mutations in CARD15 have recently been found in patients with Crohn disease (CD), a chronic inflammatory condition of the digestive tract. Here, we report the mutational analyses of CARD15 in 453 patients with CD, including 166 sporadic and 287 familial cases, 159 patients with ulcerative colitis (UC), and 103 healthy control subjects. Of 67 sequence variations identified, 9 had an allele frequency >5% in patients with CD. Six of them were considered to be polymorphisms, and three (R702W, G908R, and 1007fs) were confirmed to be independently associated with susceptibility to CD. Also considered as potential disease-causing mutations (DCMs) were 27 rare additional mutations. The three main variants (R702W, G908R, and 1007fs) represented 32%, 18%, and 31%, respectively, of the total CD mutations, whereas the total of the 27 rare mutations represented 19% of DCMs. Altogether, 93% of the mutations were located in the distal third of the gene. No mutations were found to be associated with UC. In contrast, 50% of patients with CD carried at least one DCM, including 17% who had a double mutation. This observation confirmed the gene-dosage effect in CD. The patients with double-dose mutations were characterized by a younger age at onset (16.9 years vs. 19.8 years; P=.01), a more frequent stricturing phenotype (53% vs. 28%; P=.00003; odds ratio 2.92), and a less frequent colonic involvement (43% vs. 62%; P=.003; odds ratio 0.44) than were seen in those patients who had no mutation. The severity of the disease and extraintestinal manifestations were not different for any of the CARD15 genotypes. The proportion of familial and sporadic cases and the proportion of patients with smoking habits were similar in the groups of patients with CD with or without mutation. These findings provide tools for a DNA-based test of susceptibility and for genetic counseling in inflammatory bowel disease.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                diges
                Revista Española de Enfermedades Digestivas
                Rev. esp. enferm. dig.
                Sociedad Española de Patología Digestiva (Madrid, Madrid, Spain )
                1130-0108
                October 2007
                : 99
                : 10
                : 570-575
                Affiliations
                [02] Oviedo orgnameHospital Universitario Central de Asturias orgdiv1Servicio de Inmunología
                [04] orgnameHospital Clínico Universitario de Valladolid y Grupo de Estudio de Inmunología de las Mucosas orgdiv1Departamentos de Pediatría e Inmunología
                [01] orgnameHospital Universitario Central de Asturias orgdiv1Servicio de Aparato Digestivo
                [05] orgnameHospital Clínico Universitario de Santiago de Compostela orgdiv1Servicio de Aparato Digestivo
                [03] orgnameHospital Clínico Universitario de Valladolid y Grupo de Estudio de Inmunología de las Mucosas orgdiv1Unidad de Investigación
                Article
                S1130-01082007001000002
                10.4321/s1130-01082007001000002
                56952258-104b-4958-87c9-6e99ec254bd8

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 International License.

                History
                : 17 July 2007
                : 29 April 2007
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 48, Pages: 6
                Product

                SciELO Spain


                Enfermedad de Crohn (EC),Mutaciones del gen CARD15,Frecuencia de portadores,Fenotipos,Crohn's disease,CARD15 mutations,Carrier frequencies,Fenotypes

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