Document Detail


NOD2/CARD15 does not influence response to infliximab in Crohn's disease.
MedLine Citation:
PMID:  12105838     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND & AIMS: NOD2/CARD15 was recently identified as the first gene underlying Crohn's disease (CD) susceptibility. Monoclonal antibodies to tumor necrosis factor (TNF)-alpha (infliximab) are a potent treatment for CD, with about 70% of patients responding. It is not clear which factors influence treatment outcome. We assessed whether variants in NOD2/CARD15 are predictive for differences in clinical response. METHODS: Two hundred forty-five CD patients (86 fistulizing, 159 luminal) receiving infliximab in an expanded access program were genotyped for the 3 main associated variants of NOD2/CARD15, without knowledge of the treatment response. Short-term clinical response was assessed at 4 weeks (refractory) or 10 weeks (fistulizing) after first infliximab infusion, and the mean duration of response was calculated. In a subgroup of patients, production of TNF in response to lipopolysaccharide (LPS) in mucosal biopsy tissue was also determined by means of immunoassay, and results were related to the different NOD2/CARD15 genotypes. RESULTS: In total, 32.6% of patients carried mutations in NOD2/CARD15 (18.8% R702W, 8.6% G908R, and 10.2% 1007fs) compared with 15% in controls (P < 0.001). Despite observed differences in TNF production in mucosal biopsy tissue, there was no relationship between the overall presence of a mutation in NOD2/CARD15 or of any of the mutations separately and short-term infliximab response or response duration. Furthermore, multivariate analysis could not identify clinical characteristics that, in combination with NOD2/CARD15 mutations, were associated with response to infliximab. CONCLUSIONS: In this cohort of CD patients, the frequency of NOD2/CARD15 mutations was significantly greater than that of healthy controls. However, NOD2/CARD15 was not predictive of treatment outcome with infliximab in CD.
Authors:
Severine Vermeire; Edouard Louis; Paul Rutgeerts; Martine De Vos; Andre Van Gossum; Jacques Belaiche; Paul Pescatore; Rene Fiasse; Paul Pelckmans; Robert Vlietinck; Françoise Merlin; Habib Zouali; Gilles Thomas; Jean-Frederic Colombel; Jean-Pierre Hugot;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Gastroenterology     Volume:  123     ISSN:  0016-5085     ISO Abbreviation:  Gastroenterology     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-07-09     Completed Date:  2002-08-16     Revised Date:  2008-05-13    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  106-11     Citation Subset:  AIM; IM    
Affiliation:
Department of Gastroenterology, UZ Gasthuisberg, Leuven, Belgium.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antibodies, Monoclonal / therapeutic use*
Carrier Proteins / genetics*
Cohort Studies
Crohn Disease / drug therapy*,  genetics*,  metabolism
Female
Gastrointestinal Agents / therapeutic use*
Gene Frequency
Genotype
Humans
Intracellular Signaling Peptides and Proteins*
Male
Nod2 Signaling Adaptor Protein
Predictive Value of Tests
Reference Values
Treatment Outcome
Tumor Necrosis Factor-alpha / biosynthesis
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Carrier Proteins; 0/Gastrointestinal Agents; 0/Intracellular Signaling Peptides and Proteins; 0/NOD2 protein, human; 0/Nod2 Signaling Adaptor Protein; 0/Tumor Necrosis Factor-alpha; 0/infliximab

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