Subject(s)
Cholangitis, Sclerosing/complications , Colitis, Ulcerative/complications , Crohn Disease/complications , Adult , Antibodies, Antineutrophil Cytoplasmic , Autoantibodies/analysis , Cholangitis, Sclerosing/epidemiology , Colitis, Ulcerative/epidemiology , Crohn Disease/epidemiology , Cross-Sectional Studies , Female , Germany/epidemiology , Humans , Incidence , Male , Prospective StudiesABSTRACT
Crohn's disease (CD) and multiple sclerosis (MS) share familial occurrence and similar epidemiological traits. Apart from one report of both diseases occurring among consanguineous relatives, only three cases of CD and MS in the same patient have thus far been described. We describe here a 29-year-old woman in whom MS developed in 1983 and CD in 1989. The MS may have been the result of a strongly HLA-associated genetic predisposition, while the additional development of CD may have been due either to genetic factors or perhaps simply to chance. Viewing this case in the context of epidemiological data, however, we suggest that the development of CD and MS is based on one or more common genetic factors acting in conjunction with other presumably exogenous factors and triggering HLA antigens to lead to one disease or the other.
Subject(s)
Crohn Disease/genetics , Multiple Sclerosis/genetics , Adult , Biopsy , Crohn Disease/pathology , Genetic Markers/genetics , Humans , Intestinal Mucosa/pathology , Male , Multiple Sclerosis/pathology , Neurologic Examination , Risk Factors , Tomography, X-Ray ComputedABSTRACT
Evidence of strong genetic markers in Crohn's disease (CD) is still absent. Many investigations have focused on HLA antigens, with conflicting results. To obtain more detailed information on the relation of HLA to the disease, we used the HLA data from 269 CD patients to compute the maximum-likelihood estimates of HLA gene and haplotype frequencies. These results provide further evidence that HLA B44 and Cw5 do indeed play a role in the development of CD. Furthermore, it is conceivable from our results that HLA Cw7 may protect against being affected with this disease.
Subject(s)
Crohn Disease/genetics , Gene Frequency/genetics , HLA Antigens/genetics , Haplotypes/genetics , Chi-Square Distribution , HumansABSTRACT
Immunological disorders seem to be of considerable relevance to the pathogenesis of Crohn's disease (CD). T-cells play a central role in immunoregulation. The T-cell subpopulations of 70 patients with CD were compared to those of age- and sex-matched healthy controls. The suppressor-inducer subpopulations were found to be reduced in CD patients irrespective of wether they were taking steroids or not. In contrast to other subpopulations suppressor-inducer cells remained unchanged during follow-up. The results point to a disturbance in the regulation of suppressor T-cells in patients with Crohn's disease.
Subject(s)
Crohn Disease/immunology , T-Lymphocytes/immunology , Adrenal Cortex Hormones/therapeutic use , Adult , Antigens, Differentiation, T-Lymphocyte/analysis , Azathioprine/therapeutic use , Crohn Disease/drug therapy , Female , Humans , Leukocyte Count/drug effects , Male , T-Lymphocytes, Cytotoxic/immunology , T-Lymphocytes, Helper-Inducer/immunology , T-Lymphocytes, Regulatory/immunologyABSTRACT
Inflammatory bowel diseases (IBD) as Crohn's disease (CD) and ulcerative colitis (UC) are believed to have a genetic basis. Additional factors are supposed to promote the development of IBD. However, apart from a few reports of HLA associations which await confirmation by other groups strong associations to (a) particular genetic marker(s) are still lacking. We here report on previously unobserved associations of CD to MNSS and UC to the immunoglobulin heavy chain allotype Gm 1,-2,10. We suggest that these factors play a role in a wider spectrum of genetic markers for the development of IBD.
Subject(s)
Carboxylesterase , Colitis, Ulcerative/genetics , Crohn Disease/genetics , Genetic Markers , Acid Phosphatase/genetics , Adenosine Deaminase/genetics , Adenylate Kinase/genetics , Alanine Transaminase/genetics , Blood Group Antigens/genetics , Carboxylic Ester Hydrolases/genetics , Erythrocytes/enzymology , Humans , Immunoglobulin Gm Allotypes/genetics , Phenotype , Phosphoglucomutase/genetics , Phosphogluconate Dehydrogenase/genetics , Polymorphism, GeneticABSTRACT
In a consecutive case study 231 patients with Crohn's disease were investigated for ankylosing spondylitis (AS) and HLA-A, B, C, DR antigen association. Eighteen patients (7.8%) had definite AS according to the New York criteria; 13 (72%) were HLA-B27 positive. The phenotype B27,B44 was seen in 8 patients (44%) compared to only 3 (1%) of 300 controls (p less than 10(-7), and 1 (0.5%) of 213 patients with Crohn's disease without AS (p less than 10(-7). We conclude that patients with the phenotype B27,B44 are highly at risk (relative risk = 68.8) for the common manifestation of Crohn's disease and AS.
Subject(s)
Crohn Disease/complications , HLA-B Antigens/analysis , Spondylitis, Ankylosing/complications , Adult , Crohn Disease/immunology , Disease Susceptibility , Female , HLA-B27 Antigen , HLA-B44 Antigen , HLA-C Antigens/analysis , Humans , Male , Middle Aged , Phenotype , Risk Factors , Spondylitis, Ankylosing/immunologyABSTRACT
Genetic influence on the development of Crohn's disease (CD) is commonly accepted. However, proof of definite genetic markers is still pending. Most investigations have focused on HLA antigens, and associations with HLA B12 and HLA A2 have been reported, but the design of these retrospective studies is open to criticism. We have undertaken a consecutive study of 96 patients with CD under well-defined conditions in order to test the hypothesis that CD is associated with particular HLA antigens. Our results identify a significant association of CD with the phenotype HLA B44,Cw5. But since a major proportion of the CD patients do not bear this phenotype, other predisposing genetic factors, which have not yet been defined, may exist in addition to environmental factors.
