Clarifying Crohn’s

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PHILADELPHIA—At the same time that researchers at the Children's Hospital of Philadelphia (CHOP) were identifying a new gene that increases the risk for children developing type 1 diabetes (see Divining origins of diabetes), the same group also used genome-wide association studies to confirm a linkage between Crohn's disease and ATG16L1, a gene involved in the body's defense against invading bacteria. The study was published in Gut.

"If an excess of bacteria is the problem, we may find antibiotics effective in treating this type of Crohn's disease," says Dr. Robert N. Baldassano, director of the Center for Pediatric Inflammatory Bowel Disease at CHOP. "Other approaches may be to use immune-boosting drugs to blunt the inflammation, or determining whether particular foods interact with genetic susceptibilities to affect disease symptoms. Understanding gene influences gives us a more targeted way to look at disease physiology, and also may suggest targets for treatment."
The gene had been first identified earlier in 2007 by researchers at Kiel, Germany-based Christian-Albrechts University and described in a study published in Nature Genetics. What makes the CHOP study special, however, is that whereas the German study involved adult patients with Crohn's, the new research examined children.
According to CHOP researcher Dr. Hakon Hakonarson, there are two advantages to studying diseases in children. First, early onset of a disease is likely to be more strongly influenced by genetics because confounding environmental factors have had less time to build up in children as opposed to adults. Second, studies with children open the door to the testing of parents, allowing the researchers to look at genetic transmission between generations and thereby avoiding patient stratification artifacts.

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