학술논문
Genetic Variants of Wnt Transcription Factor TCF-4 (TCF7L2) Putative Promoter Region Are Associated with Small Intestinal Crohn's Disease.
Document Type
Article
Author
Koslowski, Maureen J.; Kübler, Irmgard; Chamaillard, Mathias; Schaeffeler, Elke; Reinisch, Walter; Guoxing Wang; Beisner, Julia; Teml, Alexander; Peyrin-Biroulet, Laurent; Winter, Stefan; Herrlinger, Klaus R.; Rutgeerts, Paul; Vermeire, Séverine; Cooney, Rachel; Fellermann, Klaus; Jewell, Derek; Bevins, Charles L.; Schwab, Matthias; Stange, Eduard F.; Wehkamp, Jan
Source
Subject
*CROHN'S disease
*ILEUM diseases
*CELL differentiation
*PEPTIDE antibiotics
*NUCLEOTIDES
*GENETIC polymorphisms
*INFLAMMATORY bowel diseases
*ULCERATIVE colitis
*IRRITABLE colon
*PATIENTS
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Language
ISSN
1932-6203
Abstract
Reduced expression of Paneth cell antimicrobial α-defensins, human defensin (HD)-5 and -6, characterizes Crohn's disease (CD) of the ileum. TCF-4 (also named TCF7L2), a Wnt signalling pathway transcription factor, orchestrates Paneth cell differentiation, directly regulates the expression of HD-5 and -6, and was previously associated with the decrease of these antimicrobial peptides in a subset of ileal CD. To investigate a potential genetic association of TCF-4 with ileal CD, we sequenced 2.1 kb of the 59 flanking region of TCF-4 in a small group of ileal CD patients and controls (n = 10 each). We identified eight single nucleotide polymorphisms (SNPs), of which three (rs3814570, rs10885394, rs10885395) were in linkage disequilibrium and found more frequently in patients; one (rs3814570) was thereby located in a predicted regulatory region. We carried out high-throughput analysis of this SNP in three cohorts of inflammatory bowel disease (IBD) patients and controls. Overall 1399 healthy individuals, 785 ulcerative colitis (UC) patients, 225 CD patients with colonic disease only and 784 CD patients with ileal involvement were used to determine frequency distributions. We found an association of rs3814570 with ileal CD but neither with colonic CD or UC, in a combined analysis (allele positivity: OR 1.27, 95% CI 1.07 to 1.52, p = 0.00737), which was the strongest in ileal CD patients with stricturing behaviour (allele frequency: OR 1.32, 95% CI 1.08 to1.62, p = 0.00686) or an additional involvement of the upper GIT (allele frequency: OR 1.38, 95% CI 1.03 to1.84, p = 0.02882). The newly identified genetic association of TCF-4 with ileal CD provides evidence that the decrease in Paneth cell α-defensins is a primary factor in disease pathogenesis. [ABSTRACT FROM AUTHOR]