The molecular classification of the clinical manifestations of Crohn's disease

Tariq Ahmad, Alessandro Armuzzi, Mike Bunce, Kim Mulcahy-Hawes, Sara E. Marshall, Timothy R. Orchard, Jonathan Crawshaw, Oliver Large, Arjuna De Silva, Julia T. Cook, Martin Barnardo, Sue Cullen, Ken I. Welsh, Derek P. Jewell

    Research output: Contribution to journalArticlepeer-review

    546 Citations (Scopus)

    Abstract

    Background & Aims: Crohn's disease is a common inflammatory disorder of the gut characterized by variation in both location and behavior. Chromosome 16 and the HLA region on chromosome 6 have been implicated in susceptibility to disease. Mutations in the NOD2/ CARD15 gene, recently identified on chromosome 16, have been associated with disease overall but are found in only 25% of patients. No data regarding their contribution to specific disease subtypes exist. Here we report a detailed genotype-phenotype analysis of 244 accurately characterized patients. Methods: A total of 244 white patients with Crohn's disease recruited from a single center in the United Kingdom were studied. All patients were rigorously phenotyped and followed-up for a median time of 16 years. By using linkage disequilibrium mapping we studied 340 polymorphisms in 24 HILA genes and 3 NOD2/CARD15 polymorphisms. Results: We show that NOD2/CARD15 mutations determine ileal disease only. We confirm that alleles on specific long-range HLA haplotypes determine overall susceptibility and describe novel genetic associations with susceptibility, location, and behavior of Crohn's disease. Conclusions: The clinical pattern of Crohn's disease may be defined by specific genotypes. This study may provide the basis for a future molecular classification of disease.
    Original languageEnglish
    Pages (from-to)854-866
    Number of pages13
    JournalGastroenterology
    Volume122
    Issue number4
    DOIs
    Publication statusPublished - Apr 2002

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