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Differences between adults and children: genetics and beyond.

Thomas Billiet1, Severine Vermeire

  • 1Department of Gastroenterology, University Hospitals Leuven, Herestraat 49 - B-3000 Leuven Belgium.

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|August 20, 2014
PubMed
Summary

Pediatric inflammatory bowel disease (IBD) shows distinct clinical features and treatment approaches compared to adult IBD. Very early-onset IBD, particularly before age 2, is strongly linked to genetic factors like IL10 pathway defects.

Keywords:
Crohn’s diseaseIL-10R mutationsgeneticsgenome-wide association studiesinflammatory bowel diseaseulcerative colitisvery early-onset IBD

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Area of Science:

  • Gastroenterology and Immunology
  • Pediatric Medicine
  • Genetics

Background:

  • Clinical and epidemiological studies reveal significant differences in disease course and phenotypes between pediatric inflammatory bowel disease (IBD) and adult-onset IBD.
  • Therapeutic strategies for young-onset IBD differ, often involving earlier azathioprine use and cautious systemic steroid administration to mitigate impacts on growth and bone mineral density.
  • These clinical distinctions have spurred extensive scientific and genetic research into pediatric IBD.

Purpose of the Study:

  • To review and clarify key aspects of pediatric inflammatory bowel disease (IBD).
  • To address common questions regarding the differences between pediatric and adult IBD.
  • To provide concise information on the genetic underpinnings of very early-onset IBD.

Main Methods:

  • Review of clinical observations and epidemiological studies on pediatric IBD.
  • Analysis of genetic studies, including candidate gene and genome-wide association studies (GWAS) in pediatric IBD cohorts.
  • Focus on genetic susceptibility and specific genetic defects, particularly in the IL10 signaling pathway.

Main Results:

  • No significant differences in genetic susceptibility identified for pediatric IBD compared to adult IBD, except for very early-onset cases.
  • Very early-onset IBD (before age 2) demonstrates a strong genetic basis.
  • Defects in the Interleukin-10 (IL10) signaling pathway are a primary example of genetic causes in very early-onset IBD.

Conclusions:

  • While general pediatric IBD shares genetic susceptibility with adult forms, very early-onset IBD represents a distinct genetic disorder.
  • Genetic factors, especially IL10 pathway mutations, are crucial in the pathogenesis of IBD presenting before the age of two.
  • Understanding these genetic differences is vital for targeted therapeutic approaches in young children with IBD.