Association between two single base polymorphisms of intercellular adhesion molecule 1 gene and inflammatory bowel disease

Aim: The present study evaluated the association between G241R and K469E polymorphisms of intercellular adhesion molecule 1 gene and inflammatory bowel disease in Iranian population

Background: Inflammatory bowel disease including ulcerative colitis and Crohn's disease, is a chronic idiopathic inflammatory disease of the gastrointestinal tract. There are two single base polymorphisms of intercellular adhesion molecule 1gene, G241R and K469E, reported to be associated with inflammatory disorders

Patients and methods: In this case-control study, 156 inflammatory bowel disease patients [110 ulcerative colitis and 46 Crohn's disease patients] and 131 healthy controls were enrolled. Two polymorphisms of intercellular adhesion molecule 1gene, including G241R and K469E, were assessed by polymerase chain reaction followed by restriction fragment length polymorphism

Results: The E469 allele of K469E polymorphism was significantly more frequent in Crohn's disease patients compared to controls [P< 0.05, OR= 1.83; 95% CI: 1.13 to 2.96]. The mutant homozygote genotype of K469E polymorphism [E/E] was also significantly more frequent in Crohn's disease patients compared to controls [P< 0.05, OR= 4.23; 95% CI: 1.42 to 12.59]. No difference was observed in the frequency of K469E polymorphism among ulcerative colitis patients compared to controls. There were no significant differences in genotype and allele frequencies of G241R polymorphism among ulcerative colitis and Crohn's disease patients compared to control subjects

Conclusion: According to our findings, K469E polymorphism of intercellular adhesion molecule 1 gene may probably participate in the pathogenesis of Crohn's disease in Iran

Time trend analysis and demographic features of inflammatory bowel disease in Tehran

This retrospective study is aimed to review demographic and clinical characteristics of IBD to elucidate the probable factors associating with IBD development in Taleghani Hospital in Iran since 2001 during a 12-year-period. Ulcerative colitis [UC] and Crohn's disease [CD] are two major idiopathic entities of inflammatory bowel disease [IBD]. Previous studies have reported an increased incidence of IBD in Middle East countries. In the present study 1914 patients with UC, 318 patients with CD and 25 with indeterminate colitis [IC] were included. Demographic information, clinical features, extraintestinal manifestations, complications and extension of disease were collected and interpreted for all participants. According to the time of registration, patients were divided into seven groups. Statistical analysis was performed using the chi-square test. In seven groups of IBD patients, disease registry was estimated for UC, CD, and total IBD during a 12-year-period. From 2001 to 2005, a relative increased registry was observed among UC patients. However, in the years 2006 and 2007 a significant reduction in the number of patients was reported. Then an increasing trend was observed in UC patients. UC presented mostly with diarrhea, hematochezia and bloody diarrhea, while most of CD patients complained of abdominal pain. Evaluation of data related to registered IBD patients in Iran shows that probable incidence and prevalence of IBD [UC and CD] is increasing compared to previous decades

Association of tumor necrosis factor alpha gene polymorphisms with inflammatory bowel disease in Iran

Inflammatory bowel disease [IBD] is a chronic disease of unknown etiology, in which genetic factors, seem to play an important role in the disease predisposition and course. Assessment of tumor necrosis factor [TNF- alpha] gene polymorphisms in many populations showed a possible association with IBD. Considering the genetic variety in different ethnic groups, the aim of the present study was to investigate the association of five important single nucleotide polymorphisms [SNPs] in the promoter region of [TNF- alpha] gene with IBD in Iran. In this case-control study, 156 Ulcerative colitis [UC] patients, 50 Crohn's disease [CD] patients and 200 sex and age matched healthy controls of Iranian origin were enrolled. The study was performed during a two year period [2008-2010] at Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. DNA samples were evaluated for [TNF- alpha] gene polymorphisms [including -1031, -863, -857, -308 and -238] by PCR and RFLP methods. The frequency of the mutant allele of -1031 polymorphism was significantly higher in Iranian patients with Crohn's disease compared to healthy controls [P=0.01, OR=1.92; 95% CI: 1.14-3.23]. None of the other evaluated polymorphisms demonstrated a significant higher frequency of mutant alleles in Iranian IBD patients compared to controls. Among the five assessed [SNPs], only -1031 polymorphism of [TNF- alpha] gene may play a role in disease susceptibility for Crohn's disease in Iran. This pattern of distribution of [TNF- alpha] gene polymorphisms could be specific in this population

Economic burden of gastro-oesophageal reflux disease and dyspepsia: a community-based study

Gastro-oesophageal reflux disease [GERD] and dyspepsia are common digestive disorders that inflict serious harm, burden and economic consequences on individuals worldwide. The aim of this study was to estimate the direct and indirect economic burden of GERD and dyspepsia in the whole population of Tehran, the capital of Iran. The study was performed on a total of 18,180 adult subjects [age > 18 years] taken as a random sample in Tehran province, Iran [2006-2007]. A valid and reliable questionnaire was used to enquire about the symptoms of GERD, dyspepsia and the frequency of the utilization of health services including physician visits, hospitalisations and productivity loss due to GERD/dyspepsia symptoms in the preceding 6 months. GERD was found in 518 [41.9% males] patients and dyspepsia in 404 patients [38.9% males]. Further 1007 subjects had both GERD and dyspepsia. The total direct costs of disease per patient for GERD, dyspepsia and their overlap were PPP$97.70, PPP$108.10 and PPP$101.30, respectively [PPP, purchasing power parity dollars]. The total indirect cost of disease per patient was PPP$13.7, PPP$12.1 and PPP$32.7, for GERD, dyspepsia and their overlap, respectively. According to our results, hospitalisation and physician visits were the main cost of disease that could be minimized by revision of the insurance business in Iran

[Frequency of colorectal cancer in healthy individual's relatives: a cross-sectional population-based study]

Family history of colorectal cancer has been shown to be related to the risk of developing colorectal cancer. This risk depends on the number of affected relatives and the age at diagnosis. In this study we aimed to estimate the frequency of a positive family history of colorectal cancer in a random sample from Tehran population. This study was a community-based cross-sectional survey conducted from May 2006 to December 2007 in Tehran province, Iran. A total of 5,500 peoples [age >/= 20 years] drawn up randomly by random sampling according to postal codes and invited to participate in the study. All participants completed a detailed health data registry form on family history status of colorectal cancer. The mean age of men with a positive family history was significantly different from men with negative family history. There was no significant difference between mean age of women responders with or without positive family history. Among all participants [n=5,500], 162 responders [2.9%] had a history of colorectal cancer. Of 162, 67 responders [1.22%] had one and 4[0.07%] had two or more first-degree relative with colorectal cancer. Of 5,500 participants, 18 subjects [0.33%] reported having two or more first-degree relative with colorectal cancer or one first-degree relative with colorectal cancer diagnosed at age<50 years. Four subjects [0.07%] had three or more first-degree relative with colorectal cancer. Based on the findings, we estimate that more than 570,000 subjects in the Iran in the age group >/= 20 years have at least two to three times increased risk of developing colorectal cancer which should be identified and encourage to participate in screening and surveillance protocols of colorectal cancer

[NOD2 novel mutations in Iranian Crohn's patients]

Despite the reported role of three common mutations of the CARD15/NOD2 gene including R702W, G908R and 1007fs in Crohn's disease [CD], only about 30% of Iranian CD patients carry one of these three variants [R702W]. The aim of this study was to screen the hot points of NOD2 gene to find any novel sequence variations in Iranian patients with CD. Eighty non-related Crohn's patients from Iranian origin, referred to a tertiary center in a three-year period [2006-2009], were enrolled in this study. The hot points of NOD2 gene [including exons 4 and 8] were evaluated by direct sequencing after amplification of related sequences with polymerase chain reaction [PCR]. A total of 17 sequence variations were identified among these exons of NOD2 gene including 7 novel ones. Three of these new mutations had an allele frequency more than 5%. All new mutations were a consequence of a single nucleotide change, 4 resulted in an aminoacid change while one formed a stop coden. No deletion or insertion mutation was observed in this part of the gene. This study demonstrated the existence of uncommon NOD2 variants in Iranian patients with CD. It is possible that these mutations play a role in susceptibility to CD in Iranian population

Bloating in irritable bowel syndrome

The purpose of this study was to describe the occurrence of self report bloating and related factors n patients with irritable bowel syndrome [IBS]. Bloating symptoms are common in patients with IBS and have significant impact on normal daily function. This study was a community-based cross-sectional survey that conducted using a valid questionnaire base on Rome III criteria. Univariate analysis was used for investigation about distribution of self reported bloating according to demographic and psychological factors in irritable bowel syndrome patients. Out of 18180 subjects under study, 198 cases met criteria for the diagnosis of the irritable bowel syndrome according to criteria ROME III and 61.6% reported bloating symptoms. Bloating symptoms were more prevalent among patients with intermittent symptoms and diarrhea that in patients with constipation. Catastrophic events and depression were independent risk factors for bloating. Findings of this study support the clinical impression regarding the high prevalence of bloating symptoms in patients with irritable bowel syndrome. Further studies are needed to understand the role of physiological and psychological factors and their interaction in development of bloating in irritable bowel syndrome patients

Functional bowel disorders in Iranian population using Rome III criteria

To study the prevalence and risk factors of functional bowel disorders [FBD] in Iranian community using Rome III criteria. This study was a cross-sectional household survey conducted from May 2006 to December 2007 in Tehran province, Iran, including 18, 180 participants who were selected randomly and interviewed face-to-face by a validated questionnaire based on Rome III criteria. In all, 1.1% met the Rome III criteria for irritable bowel syndrome [IBS], 2.4% for functional constipation [FC], and 10.9% of the participants had any type of FBD. Among participants with functional dyspepsia, 83.3% had FBD; the majority cases were unspecified functional bowel disorder [U-FBD]. Of the subjects fulfilling the IBS criteria, IBS with constipation [52%] was the most frequent subtype. In the multivariate analysis, women had a higher risk of any FBDs than men, except for functional diarrhea [FD]. The prevalence of FBD, FC and FD increased and IBS decreased with increasing age. Marital status was only associated with a decrease in the risk of FBD and FD, respectively. IBS subtypes compared with FC and FD. There was no significant difference between FC and IBS with constipation [IBS-C], except for self-reported constipation; while, IBS with diarrhea [IBS-D] had more symptoms than FD. This study revealed a low rate of FBDs among the urban population of Tehran province. The ROME III criteria itself, and the problems with interpretation of the data collection tool may have contributed in underestimating the prevalence of FBD. In addition the reliability of recall over 6 months in Rome III criteria is questionable for our population