Genetic risk factors for serious infections in inflammatory bowel diseases. (4th May 2017)

• Record Type: Journal Article
• Authors: Sasidharan, Saranya; Yajnik, Vijay; Khalili, Hamed; Garber, John; Xavier, Ramnik; Ananthakrishnan, Ashwin N.
• Is Part Of: Scandinavian journal of gastroenterology. Volume 52:Number 5(2017)
• Page Start: 570
• Page End: 576
• Publication Date: 2017-05-04
• Subjects: Genetics -- infections -- pneumonia -- immunosuppression -- Crohn's disease -- sepsis; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; 616.33
• DOI: 10.1080/00365521.2017.1286381
• Languages: English
• ISSNs: 0036-5521

Abstract

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.