Increased risk of both ulcerative colitis and Crohn's disease in a population suffering from COPD.
Chronic obstructive pulmonary disease (COPD) is characterized by chronic inflammation of the airways. In the majority of cases, the inflammation is triggered by tobacco smoke. Smoking also affects the pathogenesis of inflammatory bowel disease (IBD), protecting against ulcerative colitis (UC) and promoting development of Crohn's disease (CD). The present study was undertaken to investigate occurrence of IBD among COPD patients, indicating common inflammatory pathways and shared vulnerability on a genetic basis. The study was designed as a population-based cohort study. All individuals discharged with a diagnosis of COPD from 1987 to 2002 were identified in the Swedish Inpatient Register (n=180,239). Controls and first-degree relatives of both cases and controls were identified using the Multi-Generation Register. Finally, all individuals (n=1,174,557) were compared with the Inpatient Register, identifying discharges with a diagnosis of UC or CD. Hazard ratios (HR) for IBD were determined by Cox proportional hazards regression analysis. COPD patients had a significantly higher risk of both UC (HR 1.83; 95% CI 1.61-2.09) and CD (HR 2.72; 95% CI 2.33-3.18). Among first-degree relatives of COPD patients, there was also an overall increased risk of CD (HR 1.25; 95% CI 1.09-1.43) but not of UC (HR 1.09; 95% CI 0.96-1.23). The kinship of first-degree relatives displayed an increased risk of both UC and CD among siblings (HR 1.49; 95% CI 1.15-1.91 and HR 1.46; 95% CI 1.12-1.89, respectively). The results suggest that COPD and IBD may have inflammatory pathways in common, including genetic variants of genes predisposing for disease.
Ekbom
Anders
A
Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.|Department of Epidemiology, Harvard School of Public Health, Boston, MA, 02115, USA.
Brandt
Lena
L
Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Granath
Fredrik
F
Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Löfdahl
Claes-Göran
CG
Section for Respiratory Medicine and Allergology, Department of Clinical Sciences, Lund University, BMC B14, Tornavägen 10, Lund, 221 84, Sweden.
Egesten
Arne
A
Section for Respiratory Medicine and Allergology, Department of Clinical Sciences, Lund University, BMC B14, Tornavägen 10, Lund, 221 84, Sweden. Arne.Egesten@med.lu.se.
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003093:Colitis, Ulcerative / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology