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World J Gastroenterol. Dec 28, 2011; 17(48): 5246-5259
Published online Dec 28, 2011. doi: 10.3748/wjg.v17.i48.5246
Role of genetics in the diagnosis and prognosis of Crohn's disease
Epameinondas V Tsianos, Konstantinos H Katsanos, Vasileios E Tsianos
Epameinondas V Tsianos, Konstantinos H Katsanos, Vasileios E Tsianos, 1st Division of Internal Medicine and Hepato-Gastroenterology Unit, Department of Medicine, Medical School, University of Ioannina, Leoforos Stavrou Niarxou, PO Box 1186, 45110 Ioannina, Greece
Author contributions: Tsianos EV designed and critically revised the paper; Katsanos KH designed and wrote the paper; Tsianos VE performed research for acquisition of data.
Correspondence to: Epameinondas V Tsianos, MD, PhD, FEBG, AGAF, Professor of Internal Medicine, 1st Division of Internal Medicine and Hepato-Gastroenterology Unit, Department of Medicine, Medical School, University of Ioannina, Leoforos Stavrou Niarxou, PO Box 1186, 45110 Ioannina, Greece. etsianos@uoi.gr
Telephone: +30-26510-07501 Fax: +30-26510-07016
Received: March 22, 2011
Revised: June 15, 2011
Accepted: June 22, 2011
Published online: December 28, 2011
Abstract

Considering the epidemiological, genetic and immunological data, we can conclude that the inflammatory bowel diseases are heterogeneous disorders of multifactorial etiology in which hereditability and environment interact to produce the disease. It is probable that patients have a genetic predisposition for the development of the disease coupled with disturbances in immunoregulation. Several genes have so far been related to the diagnosis of Crohn’s disease. These genes are related to innate pattern recognition receptors, to epithelial barrier homeostasis and maintenance of epithelial barrier integrity, to autophagy and to lymphocyte differentiation. So far, the strongest and most replicated associations with Crohn’s disease have been demonstrated with NOD2, IL23R and ATG16L1 genes. Many genes have so far been implicated in the prognosis of Crohn’s disease and many attempts have been made for classification of genetic profiles in Crohn’s disease. CARD15 seems to be not only a susceptibility gene, but also a disease-modifier gene for Crohn’s disease. Enriching our understanding of Crohn’s disease genetics is of value, but when combining genetic data with functional data the outcome could be of major importance to clinicians.

Keywords: Crohn’s disease; Genetics; Polymorphism; Diagnosis; Prognosis; Genome-wide scan; Genetic consortium