Innate immune receptor genetic polymorphisms in pouchitis: Is CARD15 a susceptibility factor?

Carmen B. Meier, Refaat A. Hegazi, James Aisenberg, Peter E. Legnani, Naris Nilubol, Gena M. Cobrin, Richard H. Duerr, Stephen R. Gorfine, Joel J. Bauer, David B. Sachar, Scott E. Plevy

Research output: Contribution to journalArticlepeer-review

84 Scopus citations

Abstract

Background: Pouchitis is a frequent complication after ileal pouch-anal anastamosis (IPAA) for ulcerative colitis (UC). The aim of this study was to determine whether genetic polymorphisms in the innate immune receptors toll-like receptor (TLR)4 and caspase activation and recruitment domain family member 15 (CARD15) genes are associated with pouchitis. Methods: From a retrospectively ascertained cohort of patients with UC 5 to 12 years after IPAA (n = 101), subjects were classified into 3 groups: no pouchitis (n = 52); 1 to 2 episodes per year (n = 11), and more than 2 episodes per year (n = 38). Single nucleotide polymorphisms in the tlr4 gene (D299G, T399I) were determined by a real-time polymerase chain reaction-based fluorogenic probe technique; and cardI5 polymorphisms (L1007fsinsC, R702W, G908R) were determined by pyrosequencing. Results: Pouchitis affected 49% (49/101) of the study population. No correlation between pouchitis and the presence of TLR4 polymorphisms was found. The percentage of patients who harbored CARD15 mutations was significantly higher in patients with pouchitis than in patients without pouchitis (18% versus 8%; P < 0.05); 24% of pouchitis patients with more than 2 episodes per year harbored CARD15 mutations (P < 0.01 compared with the no pouchitis group). The CARD15 insertion mutation L1007fsinsC was present in 14% of patients with pouchitis and in 0% without pouchitis (P < 0.05). All patients who carried L1007fsinsC developed more than 2 episodes per year. Conclusions: CARD15 polymorphisms are seen in greater frequency in patients with pouchitis after IPAA for UC. These findings, if borne out in prospective analyses, suggest that CARD15 mutations, particularly L1007fsinsC, may predispose to the development of pouchitis after IPAA for UC.

Original languageEnglish
Pages (from-to)965-971
Number of pages7
JournalInflammatory Bowel Diseases
Volume11
Issue number11
DOIs
StatePublished - Nov 2005

Keywords

  • Caspase activation and recruitment domain family member 15 gene
  • Genetics
  • Innate immunity
  • Pouchitis
  • Toll-like receptors

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