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The results of the analysis are presented in table I;
we found a significantly higher frequency of the BclI mutated
genotype in patients with CD in comparison with healthy controls (p= 0.03,
Fisher test, OR 3.84; 95%CI 1.23-11.91), no difference was on the contrary
observed between UC patients and controls.
OR (95% CI)
Mutated vs not mutated
Heterozygous vs wild type
Table I: BclI, ER22/23EK and N363S
genotype in patients with CD, UC and controls.
The BclI polymorphism has been associated
with high systolic pressure, insulin sensitivity, body mass index and abdominal
fat distribution ; carriers of the mutated
allele have increased GC sensitivity, and higher cortisol suppression after low
dose dexamethasone . A higher frequency of the mutated genotype has been observed in this
study in patients with CD; this mutation could lead to an increased sensitivity
in peripheral and central GRs, determining a raised susceptibility to feedback
inhibition of GCs on the HPA axis. It is of interest that previous studies have
demonstrated , in a subgroup of patients
with Crohn’s disease, alterations of the HPA axis resulting in relative
This is the first study examining the possibility that IBD may be
associated withGR polymorphisms; our
results support the hypothesis that common polymorphisms in the GR gene may
have modulating effects on the relation between psychological factors and HPA
axis regulation in patients with CD. These data however need to be confirmed in
a larger group of patients.
The Authors declare no competing interest.
This research was supported by grants from the
Italian Ministry of University and Scientific Research (PRIN projects 2004065777
and 2003053403) and the Italian Ministry
of Health. Dr. Sara De Iudicibus, Dr. Gabriele Stocco and Dr. Ilenia Drigo are
recipients of research felloships from IRCCS Burlo Garofolo, Trieste.
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