1. The interleukin 1 receptor antagonist gene allele 2 as a predictor of pouchitis following colectomy and IPAA in ulcerative colitis
- Author
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Simon Jones, Angela Cox, M J Carter, Peter B. Goodfellow, Andrew J. Shorthouse, Alan J Lobo, Francesco S. di Giovine, and Gordon W. Duff
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Genotype ,Sialoglycoproteins ,medicine.medical_treatment ,Single-nucleotide polymorphism ,Minisatellite Repeats ,Pouchitis ,Gastroenterology ,Ileum ,Predictive Value of Tests ,Internal medicine ,Humans ,Point Mutation ,Medicine ,Age of Onset ,Child ,Alleles ,Colectomy ,Aged ,DNA Primers ,Retrospective Studies ,Hepatology ,business.industry ,Proportional hazards model ,Proctocolectomy ,Anastomosis, Surgical ,Infant ,Receptors, Interleukin-1 ,Interleukin ,DNA ,Middle Aged ,medicine.disease ,Survival Analysis ,Ulcerative colitis ,Interleukin 1 Receptor Antagonist Protein ,Interleukin 1 receptor antagonist ,Child, Preschool ,Immunology ,Colitis, Ulcerative ,Female ,business - Abstract
Background & Aims: The interleukin 1 receptor antagonist gene allele 2 has been suggested as a determinant of both disease susceptibility and extent in ulcerative colitis. The aim of this study was to assess the allele as a predictor of both the indication for colectomy and the occurrence of pouchitis after ileal pouch–anal anastomosis formation. Methods: Genotyping for the +2018 single nucleotide polymorphism in the interleukin 1 receptor antagonist gene was performed in 109 patients who had undergone colectomy, including 82 patients who had been followed prospectively after ileal pouch–anal anastomosis formation. Results: Patients with pouchitis had a higher allele 2 carriage rate compared with those without pouchitis (72% vs. 45%) and Kaplan–Meier survival analysis showed that allele 2 carriers had a significantly increased incidence of pouchitis compared with noncarriers (log-rank test, 6.5). After adjustment for confounding covariates in a Cox proportional hazards model, the relative hazard was 3.1 (95% confidence interval [CI], 1.2–7.8; P = 0.02). Although there was a higher allele 2 carriage rate in patients with chronic refractory compared with acute severe ulcerative colitis (63% vs. 48%), this difference was not significant (odds ratio, 1.9; 95% Cl, 0.9–4.1; P = 0.1). Conclusions: The interleukin 1 receptor antagonist gene allele 2 predicts pouchitis after ileal pouch-anal anastomosis in ulcerative colitis. GASTROENTEROLOGY 2001;121:805-811
- Published
- 2001