Genetic risk factors for serious infections in inflammatory bowel diseases.

Abstract:

INTRODUCTION:Immunosuppression, the cornerstone of management of Crohn's disease (CD) and ulcerative colitis (UC) (inflammatory bowel diseases; IBD) is associated with an increased risk of serious infections that is inadequately predicted by clinical risk factors. The role of genetics in determining susceptibility to infections is unknown. METHODS:From a prospective-consented patient registry, we identified IBD patients with serious infections requiring hospitalization. Analysis was performed to identify IBD-related and non-IBD related immune response loci on the Immunochip that were associated with serious infections and a genetic risk score (GRS) representing the cumulative burden of the identified single nucleotide polymorphisms was calculated. Multivariable logistic regression used to identify effect of clinical and genetic factors. RESULTS:The study included 1333 IBD patients (795 CD, 538 UC) with median disease duration of 13 years. A total of 133 patients (10%) had a serious infection requiring hospitalization. Patients with infections were more likely to have CD and had shorter disease duration. The most common infections were skin and soft-tissue, respiratory and urinary tract infections. Eight IBD risk loci and two other polymorphisms were significantly associations with serious infections. Each one point increase in the infection GRS was associated with a 50% increase in risk of infections (OR = 1.53, 95% CI = 1.37-1.70) (p = 1 × 10-14), confirmed on multivariable analysis. Genetic risk factors improved performance of a model predicting infections over clinical covariates alone (p < 0.001). CONCLUSIONS:Genetic risk factors may predict susceptibility to infections in patients with IBD.

journal_name

Scand J Gastroenterol

authors

Sasidharan S,Yajnik V,Khalili H,Garber J,Xavier R,Ananthakrishnan AN

doi

10.1080/00365521.2017.1286381

subject

Has Abstract

pub_date

2017-05-01 00:00:00

pages

570-576

issue

5

eissn

0036-5521

issn

1502-7708

journal_volume

52

pub_type

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