Gelbmann, Cornelia M. and Rogler, Gerhard and Gierend, Michael and Gross, Volker and Schoelmerich, Juergen and Andus, Tilo (2001) Association of HLA-DR genotypes and IL-1ra gene polymorphism with treatment failure of budesonide and disease patterns in Crohn's disease. EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY, 13 (12). pp. 1431-1437. ISSN 0954-691X
Full text not available from this repository. (Request a copy)Abstract
Objective Associations between HLA-DR genotypes and susceptibility to Crohn's disease (CID) have been reported. However, it is not known whether certain HLA-DR genotypes or IL-1ra gene polymorphism are associated with responsiveness to treatment or different clinical patterns of disease. Design/setting In a large, randomized, controlled multicentre trial, 318 patients with CD were treated with daily doses of 6, 9 or 18 mg budesonide. Patients were stratified into two groups: patients without steroid pretreatment and with active CID (CDAI > 150) and patients with conventional steroid pretreatment of less than or equal to 30 mg prednisolone per day, which was replaced by oral budesonide within 3 weeks. Main outcome measures The HLA-DRB1 genotypes 1-16 and the IL-1ra gene polymorphism were examined for an association with budesonide treatment failure. Results Only HLA-DR 8 was associated with treatment failure of budesonide. HLA-DR 8 is not very common. Only 17/243 patients who could be evaluated expressed this genotype, and 13 of these 17 patients did not respond to budesonide (P < 0.00067). Neither the other HLA-DR genotypes nor the IL-1ra gene polymorphisim had an influence on treatment outcome of budesonide therapy. No significant association of fistulas, perianal disease, need for bowel resections, and disease localization with certain HLA-DRB1 genotypes or the IL-1ra gene polymorphism were found. Conclusions This is the first description of an association of a certain HLA-DR genotype (HLA-DR 8) with treatment failure in inflammatory bowel disease (IBD). (C) 2001 Lippincott Williams & Wilkins.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | INFLAMMATORY-BOWEL-DISEASE; ORAL BUDESONIDE; INTESTINAL INFLAMMATION; CLINICAL-PATTERNS; SUSCEPTIBILITY; CLASSIFICATION; PREDNISOLONE; MESALAMINE; DEPENDENCY; IMBALANCE; budesonide; Crohn's disease; disease heterogeneity; HLA-DR; interleukin-1 receptor antagonist; prognostic factors; steroid resistance |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin I |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 23 Nov 2021 11:23 |
| Last Modified: | 23 Nov 2021 11:23 |
| URI: | https://pred.uni-regensburg.de/id/eprint/40892 |
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