Author(s): Koskela RM, Karttunen TJ, Niemel SE, Lehtola JK, Ilonen J,
Abstract Share this page
Abstract OBJECTIVES: Coeliac disease (CD) is common in patients with microscopic colitis (MC). The human leucocyte antigen (HLA)-DR3-DQ2 haplotype is strongly associated with CD, and there is evidence for an association with MC. We analysed the genetic background of MC by assessing the haplotypes of HLA-DR3-DQ2 and HLA-DR4-DQ8. In addition, TNFalpha gene polymorphism (-308) associated with susceptibility to several autoimmune diseases was studied. METHODS: Eighty patients with MC including 29 with collagenous colitis (CC) and 51 with lymphocytic colitis (LC) were typed for HLA-DR3-DQ2, and HLA-DR4-DQ8 molecule encoding genes using either an allele-specific PCR, or hybridization with sequence-specific oligonucleotides. Duodenal biopsies (N=78) confirmed the diagnosis of CD in 15 (18.8\%) patients. TNFalpha(308) alleles were analyzed in 78 patients with MC (27 with CC and 51 with LC). A control group of 3627 patients was used in the HLA study and 178 patients in the TNFalpha study. RESULTS: HLA-DR3-DQ2 haplotype was more frequent in patients with MC (43.8\%) including both subgroups (LC, 44.8\%; CC, 43.1\%; P<0.001), and MC with CD (86.7\%; P<0.001) and without CD (33.3\%; P=0.003), compared with the controls (18.1\%). Similarly, the TNF2 carrier rate was higher in MC (46.2\%; P<0.001) including both CC (44.4\%; P=0.031) and LC (47.1\%; P=0.001), and both MC patients with CD (66.7\%; P=0.001) and without CD (39.3\%; P=0.019), compared with the controls (23\%). CONCLUSION: Both CC and LC are associated with the HLA-DR3-DQ2 haplotype and with TNF2 allele carriage. These associations are present also in MC patients without CD. The shared predisposing HLA-DR3-DQ2 haplotype and the high prevalence of CD in patients with MC suggest an epidemiological overlap, and probably some similarities in the pathogenesis of CD and MC.
This article was published in Eur J Gastroenterol Hepatol
and referenced in International Journal of Inflammation, Cancer and Integrative Therapy