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Population-based case-control study of measles, mumps, and rubella and inflammatory bowel disease
Charles N Bernstein1, Patricia Rawsthorne, James F Blanchard
1University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Manitoba, Canada. cbernst@cc.umanitoba.ca
Background:
Previous controversy was generated over the hypothesis that a paramyxovirus such as measles or vaccination against such viruses might be causally associated with inflammatory bowel disease (IBD). We aimed to determine if Crohn's disease (CD) or ulcerative colitis (UC) subjects are more likely to be seropositive for measles, mumps, or rubella than controls.
Methods:
Using our population-based University of Manitoba IBD Research Registry we recruited CD (n = 235) and UC (n = 137) subjects ages 18-50 years for a study involving detailed questionnaires and venipuncture. We accessed the population-based databases of Manitoba Health (single provincial health insurer) to get age-, gender-, and geography-matched non-IBD controls (n = 310). We used a standard enzyme-linked immunosorbent assay (ELISA) to measure serum antibodies.
Results:
Seropositivity for measles and mumps was similar in controls (98.1%, 78.4%, respectively) as in CD (96.2%, 72.3% respectively) and in UC (95.5%, 74.6%, respectively). However, controls were significantly more likely to be seropositive for rubella (98.1%) than were CD cases (91.0%, P < 0.0002) or UC cases (93.3%, P = 0.01). Males accounted for the significantly lower rates of seropositivity to rubella with CD. While we determined that significantly more controls than CD were vaccinated, we cannot be sure if the increased rate of rubella seropositivity in controls is secondary to wildtype or vaccine-associated infection.
Conclusions:
These data suggest there is no association of having acquired measles, mumps, or rubella (by natural infection or through vaccination) and CD or UC. If anything, these data may suggest some protective effect of having acquired rubella infection or vaccine against acquiring CD.
Insights
This study found no link between measles, mumps, or rubella infection/vaccination and inflammatory bowel disease (IBD). Data suggest rubella exposure may even protect against Crohn's disease (CD) or ulcerative colitis (UC).
Area of Science:
- Gastroenterology
- Immunology
- Epidemiology
Background:
- Investigated the controversial hypothesis linking paramyxoviruses (measles, mumps, rubella) or their vaccines to inflammatory bowel disease (IBD).
- Previous research suggested a potential association, necessitating further population-based investigation.
Purpose of the Study:
- To determine if individuals with Crohn's disease (CD) or ulcerative colitis (UC) exhibit different seropositivity rates for measles, mumps, and rubella compared to healthy controls.
- To clarify the relationship between viral infections/vaccinations and IBD development.
Main Methods:
- Recruited 235 CD and 137 UC patients (ages 18-50) from the University of Manitoba IBD Research Registry.
- Utilized population-based Manitoba Health databases for 310 age-, gender-, and geography-matched controls.
- Measured serum antibodies using enzyme-linked immunosorbent assay (ELISA).
Main Results:
- Seropositivity for measles and mumps was similar across IBD patients and controls.
- Significantly lower rubella seropositivity was observed in CD and UC patients compared to controls (P < 0.0002 for CD, P = 0.01 for UC).
- Lower rubella seropositivity in CD patients was linked to males; increased control rubella seropositivity may be due to wildtype or vaccine infection.
Conclusions:
- No association found between measles, mumps, or rubella (infection or vaccination) and the development of CD or UC.
- Findings suggest a potential protective effect of rubella infection or vaccination against developing CD or UC.
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