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Genetics of Crohn disease, an archetypal inflammatory barrier disease
Genetics of Crohn disease, an archetypal inflammatory barrier disease
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Genetics of Crohn disease, an archetypal inflammatory barrier disease
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Genetics of Crohn disease, an archetypal inflammatory barrier disease
Genetics of Crohn disease, an archetypal inflammatory barrier disease
Journal Article

Genetics of Crohn disease, an archetypal inflammatory barrier disease

2005
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Overview
Key Points The aetiology of Crohn disease, as an archetypal inflammatory barrier disease, involves inherited defects in several genes that maintain the integrity of barrier function. CARD15 was identified as the first disease gene for Crohn disease; the main three variants identified all affect the ligand-binding domain of the NOD2 protein. CARD15 variants confer an almost autosomal-recessive genetic effect that is much stronger than expected for a susceptibility gene in a polygenic condition. Additional disease genes ( SLC22A4 , SLC22A5 and DLG5 ) that have small odds ratios have been identified, but their involvement remains to be confirmed in independent samples. The function of variability in susceptibility genes that leads to disease might be understood by studying evolutionary control. Epidemiological trigger factors for inflammatory barrier diseases might interact with genetic susceptibility on the individual level through alterations of the human flora on body surfaces. Chronic inflammatory disorders such as Crohn disease, atopic eczema, asthma and psoriasis are triggered by hitherto unknown environmental factors that function on the background of some polygenic susceptibility. Recent technological advances have allowed us to unravel the genetic aetiology of these and other complex diseases. Using Crohn disease as an example, we show how the discovery of susceptibility genes furthers our understanding of the underlying disease mechanisms and how it will, ultimately, give rise to new therapeutic developments. The long-term goal of such endeavours is to develop targeted prophylactic strategies. These will probably target the molecular interaction on the mucosal surface between the products of the genome and the microbial metagenome of a patient.