The interleukin 1 receptor antagonist gene allele 2 as a predictor of pouchitis following colectomy and IPAA in ulcerative colitis.
OBJECTIVE
The interleukin 1 receptor antagonist gene allele 2 has been suggested as a determinant of both disease susceptibility and extent in ulcerative colitis. The aim of this study was to assess the allele as a predictor of both the indication for colectomy and the occurrence of pouchitis after ileal pouch-anal anastomosis formation.


METHODS
Genotyping for the +2018 single nucleotide polymorphism in the interleukin 1 receptor antagonist gene was performed in 109 patients who had undergone colectomy, including 82 patients who had been followed prospectively after ileal pouch-anal anastomosis formation.


RESULTS
Patients with pouchitis had a higher allele 2 carriage rate compared with those without pouchitis (72% vs. 45%) and Kaplan-Meier survival analysis showed that allele 2 carriers had a significantly increased incidence of pouchitis compared with noncarriers (log-rank test, 6.5). After adjustment for confounding covariates in a Cox proportional hazards model, the relative hazard was 3.1 (95% confidence interval [CI], 1.2-7.8; P = 0.02). Although there was a higher allele 2 carriage rate in patients with chronic refractory compared with acute severe ulcerative colitis (63% vs. 48%), this difference was not significant (odds ratio, 1.9; 95% CI, 0.9-4.1; P = 0.1).


CONCLUSIONS
The interleukin 1 receptor antagonist gene allele 2 predicts pouchitis after ileal pouch-anal anastomosis in ulcerative colitis.
Carter
M J
MJ
The Gastroenterology and Liver Unit, University of Sheffield, Royal Hallamshire Hospital, Sheffield, England, UK. m.j.carter@shef.ac.uk
Di Giovine
F S
FS
Cox
A
A
Goodfellow
P
P
Jones
S
S
Shorthouse
A J
AJ
Duff
G W
GW
Lobo
A J
AJ
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000483:Alleles; D000714:Anastomosis, Surgical / Q000009:adverse effects* / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D003082:Colectomy / Q000009:adverse effects* / Q000401:mortality; D003093:Colitis, Ulcerative / Q000235:genetics / Q000401:mortality / Q000601:surgery*; D004247:DNA / Q000097:blood / Q000235:genetics; D017931:DNA Primers; D005260:Female; D005838:Genotype; D006801:Humans; D007082:Ileum / Q000601:surgery*; D007223:Infant; D053590:Interleukin 1 Receptor Antagonist Protein; D008297:Male; D008875:Middle Aged; D018598:Minisatellite Repeats; D017354:Point Mutation; D019449:Pouchitis / Q000209:etiology*; D011237:Predictive Value of Tests; D017472:Receptors, Interleukin-1 / Q000037:antagonists & inhibitors; D012189:Retrospective Studies; D012795:Sialoglycoproteins / Q000235:genetics*; D016019:Survival Analysis
D017931:DNA Primers; C507763:IL1RN protein, human; D053590:Interleukin 1 Receptor Antagonist Protein; D017472:Receptors, Interleukin-1; D012795:Sialoglycoproteins; D004247:DNA