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Background Recent studies suggest a role for the endocannabinoid system, including fatty acid amide hydrolase (FAAH), in intestinal inflammation. Aim To analyse FAAH expression and the FAAH 385 C/A (p.Pro129Thr; rs324420) single nucleotide polymorphism (SNP) in-patients with Crohn’s disease (CD) and ulcerative colitis (UC). Patients and methods Genomic DNA from 1008 individuals (CD: n = 435; UC: n = 167; controls: n = 406) was analysed for the FAAH 385 C/A SNP. We determined FAAH mRNA expression by quantitative PCR in CD and UC lesions as well as in intestinal epithelial cells (IECs). Results There were no significant differences regarding the frequency of this SNP in the three study groups (CD, UC, controls). However, CD patients homozygous for the FAAH p.Pro129Thr polymorphism were more likely to develop a severe disease phenotype associated with fistulas ( P = 0.03, OR 3.12, 95% CI 1.08–8.98) and extra-intestinal manifestations ( P = 0.005, OR 4.29, CI 1.49–12.35). In UC, homozygous carriers had an earlier disease onset than wild-type carriers ( P = 0.01). FAAH mRNA expression correlated with IL-8 mRNA expression in CD lesions ( r = 0.53). However, pro-inflammatory stimuli did not significantly increase FAAH mRNA expression in IECs. Conclusion The FAAH p.Pro129Thr polymorphism may modulate the CD phenotype. [ABSTRACT FROM AUTHOR]

Aim To evaluate the efficacy and safety of adalimumab, a human antitumour necrosis factor-α antibody, in induction and maintenance of remission in patients with Crohn’s disease either refractory or intolerant to infliximab in a single centre cohort. Methods Sixteen Crohn’s disease patients received 160 mg adalimumab subcutaneously in week 0, followed by 80 mg every other week. Clinical response was assessed based on Crohn’s disease activity index and laboratory parameters (leukocyte count, C-reactive protein). In all patients genotyping for CARD15 variants and the +1059G/C polymorphism in the C-reactive protein gene was performed. Results In 10 of 16 patients (63%) treated with adalimumab, remission (CDAI score <150) was induced for at least 8 weeks independent of CARD15 or +1059G/C CRP status. In six of these 10 patients ongoing remission is observed now for more than 24 weeks. Adalimumab significantly decreased C-reactive protein serum levels and Crohn’s disease activity index. There was one serious complication (fungal pneumonia). Six patients intermittently developed minor dermatological problems resolving after topical therapy. Otherwise, treatment was generally well tolerated. Conclusion Adalimumab can induce and maintain remission in patients with moderate to severe Crohn’s disease intolerant or refractory to infliximab. Further experience from larger cohorts is required to evaluate dose regimen and safety profiles in Crohn’s disease therapy. [ABSTRACT FROM AUTHOR]