ABSTRACT
Crohn's disease [CD] and ulcerative colitis [UC] have complex genetic background that is characterised by more than one susceptibility locus. To detect a possible association between the functional polymorphisms of the chemokine receptors CCR5, CCR2 and MCP-1 genes and susceptibility to CD and UC in Tunisian population, polymorphisms of CCR5-delta 32, CCR5-59029-A/G, CCR2-V64I and MCP-1-2518- G/A were analysed in 194 Inflammatory bowel disease [IBD] patients and 169 healthy blood donors using PCR-RFLP and PCR-SSP methods. The patients were classified in 126 patients with CD and 68 patients with UC. The genotypic and allelic frequencies of all polymorphisms studied, did not reveal significant differences between patients and controls, and among CD and UC patients. However, analysis of CD patients revealed that those without homozygosous G/G genotype are more frequently in remission compared to those with this genotype [OR: 0.4; 95%CI: [0.174-0.928]; p=0.03]. Also, the frequency of the CCR2-64I muted allele was statistically higher in CD patients in remission disease than those in active form [OR: 0.267; 95%CI: [0.09-0.78]; p=0.01]. Adjustment for known covariates factors [age, gender and immunosuppressive regimen] confirmed these univariate findings and revealed that the CCR5-59029-A/G and CCR2-V64I genotype were associated to remission form of CD [OR: 2.63; 95%CI: [1.01-6.80]; p=0.047 and OR: 4.64; 95%CI: [1.01-21.31]; p=0.049 respectively]. In conclusion, the present study supports the involvement of chemokine receptor [CCR2 and CCR5] polymorphisms in activity degree of the IBD disease in Tunisian patients
ABSTRACT
The frequency of Inflammatory Bowel Disease [IBD] is increasing in Tunisia. We evaluated the epidemiological, clinical and evolutive aspects of this disease with the retrospective analysis of 82 patients seen over an 11 year period. Our 82 patients included 56 women an 26 men with a sex ratio of 2,1; their median age was 32,6 years [11 to 65 years]. They were divided into two groups: group A included 61 patients with ulcerative colitis and group B 17 patients with colonic Crohn's disease. Four cases had a colotis of undetermined type. A mucous bloody diarrhea was the most prominent feature in both groups, and 9 patients from group B had anoperineal lesions. Diagnosis was made in the majority of the patients by colonoscopy [60/82] and the endoscopic and pathological diagnosis were concordant in 81,25% of the cases. In group A only 11% of the patients had extended their lesions with time; we have observed 10 cases of severe colitis [5 in group A and 5 in group B] and surgery was required in all ten cases