27 CLINICAL AND GENOMIC CORRELATES OF NEUTROPHIL GRANULOCYTE-MACROPHAGE COLONY STIMULATING FACTOR SIGNALING IN PEDIATRIC CROHN DISEASE. (18th January 2018)

• Record Type: Journal Article
• Authors: Denson, Lee A; Jurickova, Ingrid; Karns, Rebekah; Shaw, Kelly A; Cutler, David J; Okou, David; Dodd, Anne; Mondal, Kajari; Aronow, Bruce J; Haberman, Yael; Linn, Aaron; Price, Adam; Bezold, Ramona; Lake, Kathleen; Jackson, Kimberly; Walters, Thomas D; Griffiths, Anne; Baldassano, Robert N; Noe, Joshua D; Hyams, Jeffrey S; Crandall, Wallace V; Kirschner, Barbara S; Heyman, Melvin B; Snapper, Scott; Guthery, Stephen L; Dubinsky, Marla C; Leleiko, Neal S; Otley, Anthony R; Xavier, Ramnik J; Stevens, Christine; Daly, Mark J; Zwick, Michael E; Kugathasan, Subra;
• Is Part Of: Inflammatory bowel diseases. Volume 24(2018)Supplement 1
• Page Start: S7
• Page End: S8
• Publication Date: 2018-01-18
• Subjects: Inflammatory bowel diseases -- Periodicals; Colitis, Ulcerative -- Periodicals; Crohn Disease -- Periodicals; Inflammatory Bowel Diseases -- Periodicals; 616.344
• DOI: 10.1093/ibd/izy019.019
• Languages: English
• ISSNs: 1078-0998

Abstract

Abstract: Background and Aims: Neutralizing Granulocyte-Macrophage Colony Stimulating Factor auto-antibodies (GMAb) suppress neutrophil extrinsic GM-CSF signaling and increase risk for stricturing behavior in Crohn's Disease (CD). We aimed to define clinical, genomic, and functional associations with neutrophil intrinsic GM-CSF signaling in pediatric-onset CD. Methods: Missense mutations in CSF2RA, CSF2RB, JAK2, STAT5A, and STAT5B were identified using whole exome sequencing (WES) in 543 pediatric Inflammatory Bowel Disease (IBD) patients. Neutrophil intrinsic GM-CSF signaling was defined using the GM-CSF induced STAT5 stimulation index (GMSI) in 180 pediatric IBD patients and 26 non-IBD controls. Reduced GM-CSF signaling (GMSI Lo) was defined as the 20th percentile within the control group. Variation in neutrophil phospho-protein abundance, bacterial killing, and the global pattern of gene expression with the GMSI was determined. Results: We validated 18 potentially damaging missense mutations in CSF2RA and CSF2RB. CSF2RA A17G carriage increased from 10% in those with intact neutrophil GMSI to 32% in those with low GMSI (p=0.02). The frequency of reduced Staph Aureus killing increased from 17% in in those with intact neutrophil GMSI to 35% in GMSI Lo neutrophils (p=0.043). CD neutrophils with low GMSI exhibited specific alterations in phospho-protein networks and genes regulating cytokine production, wound healing, and cell survival and proliferation. Stricturing behavior increased from 7% in CD patients with both low GMAb and intact GMSI to 64% in patients with both elevated GMAb and low GMSI (p<0.0001). Conclusions: Low normal neutrophil intrinsic GM-CSF signaling is associated with CSF2RA missense mutations, alterations in cellular phospho-protein and gene expression networks, and higher rates of disease complications in pediatric CD. These data may inform new therapeutic approaches including ex vivo priming of myeloid cells by GM-CSF.