Multidrug resistance 1 gene polymorphisms may determine Crohn's disease behavior in patients from Rio de Janeiro

Glucocorticosteroid therapy in inflammatory bowel diseases: From clinical practice to molecular biology

Inflammatory bowel diseases (IBDs), such as ulcerative colitis and Crohn’s disease, are chronic pathologies associated with a deregulated immune response in the intestinal mucosa, and they are triggered by environmental factors in genetically susceptible individuals. Exogenous glucocorticoids (GCs) are widely used as anti-inflammatory therapy in IBDs. In the past, patients with moderate or severe states of inflammation received GCs as a first line therapy with an important effectiveness in terms of reduction of the disease activity and the induction of remission. However, this treatment often results in detrimental side effects. This downside drove the development of second generation GCs and more precise (non-systemic) drug-delivery methods. Recent clinical trials show that most of these new treatments have similar effectiveness to first generation GCs with fewer adverse effects. The remaining challenge in successful treatment of IBDs concerns the refractoriness and dependency that some patients encounter during GCs treatment. A deeper understanding of the molecular mechanisms underlying GC response is key to personalizing drug choice for IBDs patients to optimize their response to treatment. In this review, we examine the clinical characteristics of treatment with GCs, followed by an in depth analysis of the proposed molecular mechanisms involved in its resistance and dependence associated with IBDs. This thorough analysis of current clinical and biomedical literature may help guide physicians in determining a course of treatment for IBDs patients and identifies important areas needing further study.

Association of ABCB1 polymorphisms and ulcerative colitis susceptibility

OBJECTIVE

Multi-drug resistance gene 1 (ABCB1) is closely related to bowel diseases. Therefore, our study was aimed to evaluate the correlation between ABCB1 polymorphisms (C1236T and C3435T) and ulcerative colitis (UC) susceptibility.

METHODS

A total of 61 UC patients and 64 healthy people participated in the study. Genotyping was conducted with the method of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). χ(2) test was used to evaluate the association of ABCB1 gene polymorphisms (C1236T and C3435T) and UC susceptibility.

RESULTS

For ABCB1 C1236T polymorphism, the frequencies of CC genotype and C allele were found higher in the cases than those in the controls (CC: 36.1% vs. 20.3%; C: 58.2% vs. 41.4%), which indicated that the CC genotype and C allele might increase the risk for UC (OR = 3.39, 95% CI = 1.28-8.97; OR = 1.97, 95% CI = 1.19-3.26). However, there were no statistical differences in the genotype or allele distribution of ABCB1 C3435T between the case and control group.

CONCLUSION

The CC genotype and C allele of ABCB1 C1236T polymorphisms are significantly associated with UC susceptibility, so we conclude that ABCB1 C1236T polymorphisms might serve as genetic-susceptibility factors for UC. While, no remarkable relationship is observed between ABCB1 C3435T polymorphisms and UC.