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Apolipoprotein E variants correlate with the clinical presentation of paediatric inflammatory bowel disease: A
Aleksandra Glapa-Nowak1, Mariusz Szczepanik1, Barbara Iwańczak2
1Department of Pediatric Gastroenterology and Metabolic Diseases, Poznań University of Medical Sciences, Poznań 60-572, Poland.
Insights
Apolipoprotein E (APOE) gene variations influence inflammatory bowel disease (IBD) risk and clinical presentation. APOE polymorphisms are linked to IBD development and disease severity, though clinical relevance is modest.
Area of Science:
- Genetics
- Gastroenterology
- Pediatric Medicine
Background:
- Apolipoprotein E (APOE) gene polymorphisms have been linked to inflammatory bowel disease (IBD) risk and early onset.
- Previous research has not explored the association between APOE polymorphisms and IBD clinical characteristics or disease severity.
Purpose of the Study:
- To investigate the association between APOE polymorphisms and the risk of developing IBD.
- To examine the relationship between APOE polymorphisms and the clinical characteristics and disease severity in pediatric IBD patients.
Main Methods:
- Genotyping of 406 IBD patients (ages 3-18) using the TaqMan hydrolysis probe assay.
- Assessment of clinical expression at diagnosis and during flares, including C-reactive protein, albumin, disease activity indices, and treatment interventions.
- Evaluation of hospitalizations, relapses, and disease severity metrics.
Main Results:
- In ulcerative colitis, APOEε4 allele was associated with lower C-reactive protein levels at diagnosis and during flares.
- Crohn's disease patients with the APOEε2 allele showed lower Pediatric Crohn's Disease Activity Index scores at diagnosis.
- IBD patients with the APOEε2 allele experienced fewer hospital days due to relapse.
Conclusions:
- APOE polymorphisms are associated with both the risk of developing IBD and its clinical expression.
- The identified differences in clinical presentation related to APOE polymorphisms are modest in clinical significance.
Background:
It has been suggested that apolipoprotein E (APOE) polymorphisms are associated with the risk of developing inflammatory bowel disease (IBD) and the early age of disease onset. However, there are no reports regarding the relationship with clinical characteristics and disease severity.
Aim:
To summarise that APOE polymorphisms are associated with the risk of developing IBD and the early age of disease onset.
Methods:
In total, 406 patients aged 3-18 with IBD (192 had ulcerative colitis and 214 had Crohn's disease) were genotyped using the TaqMan hydrolysis probe assay. Clinical expression was described at diagnosis and the worst flare by disease activity scales, albumin and C-reactive protein levels, localisation and behaviour (Paris classification). Systemic steroid intake with the total number of courses, immunosuppressive, biological, and surgical treatment with the time and age of the first intervention were determined. The total number of exacerbation-caused hospitalisations, the number of days spent in hospital due to exacerbation, the number of relapses, and severe relapses were also estimated.
Results:
Ulcerative colitis patients with the APOEε4 allele had lower C-reactive protein values at diagnosis (P = 0.0435) and the worst flare (P = 0.0013) compared to patients with the APOEε2 allele and genotype APOEε3/ε3. Crohn's disease patients with the APOEε2 allele scored lower on the Pediatric Crohn's Disease Activity Index at diagnosis (P = 0.0204). IBD patients with APOEε2 allele spent fewer days in the hospital due to relapse (P = 0.0440).
Conclusion:
APOE polymorphisms are associated with the risk of developing IBD and the clinical expression of IBD. However, the clinical relevance of the differences identified is rather modest.
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