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We read with interest the article by Matsuzawa et al showing an association between the K469E allele of intercellular adhesion molecule (ICAM)-1 gene and inflammatory bowel disease (IBD) in a Japanese population (Gut 2003;52:75–8). The ICAM-1 gene lies on chromosome 19p13, previously implicated in determining susceptibility to IBD,1 and codifies for a surface glycoprotein that belongs to the immunoglobulin superfamily. ICAM-1 plays an important role in the trafficking and activation of leucocytes and is upregulated in the inflamed mucosa of IBD patients. Matsuzawa et al found that the allelic frequency of K469 was significantly higher in both Crohn’s disease (CD) and ulcerative colitis (UC) patients than controls (Gut 2003;52:75–8). These data are in contrast with the results of two previous studies from the USA2 and Germany3 which showed no significant difference in K469 allele frequency between IBD patients and healthy controls. The G241R polymorphism of the ICAM-1 gene was also investigated in these studies, and IBD patients were stratified by antineutrophil cytoplasmic antibody (ANCA) status. In particular, Yang …