Inflammatory Bowel Disease in Immigrants to Canada And Their Children: A Population-Based Cohort Study

Benchimol, Eric I; Mack, David; Guttmann, Astrid; Nguyen, Geoffrey C.; To, Teresa; Mojaverian, Nassim; Quach, Pauline; Dujovny, Manuel

doi:10.1038/ajg.2015.52

Cited by 208 publications

(157 citation statements)

References 21 publications

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“…Mortality remains increased in both the short and longer term for these patients, a point again confirmed in the current study. A recent meta-analysis by Chen et al 6 also suggests CDI is a risk factor for colectomy in IBD patients, supporting the conclusions of this current study and patients should be counselled accordingly. Antibiotic therapy remains the standard of treatment as in non-IBD-infected individuals, 7 although there is an increasing body of work in recent years to suggest faecal microbiota may have an important role to play, 8 although further studies are needed.…”

Section: Linked Contentsupporting

confidence: 72%

“…4 The Stan- The findings of this study add to the growing body of evidence supporting the complex role of environmental factors in modulating IBD risk. The Swedish population-based study by Li et al 5 and the Canadian population-based study by Benchimol et al 6 suggested that low-risk migrants over subsequent generations adopt the risk of the country to which they migrated. Consistent with the findings of the present study, our group also demonstrated an increased risk of IBD in migrants from a high incidence region, UK, to Canterbury, New Zealand where IBD incidence had previously been low.…”

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confidence: 99%

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Editorial: inflammatory bowel disease risk reduction after migration – are early life events important?

Lamba

Tharayil

Gearry

2017

Aliment Pharmacol Ther

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cotherapy have resulted in improved outcomes. However, the etio-pathogenesis of both Crohn's disease (CD) and ulcerative colitis (UC) remains poorly defined. Risk alleles determined by genome-wide association studies have been shown to only modestly increase the risk of IBD.3 Given that the recent exponential rise of IBD over the last century parallels industrialisation, significant association with specific environmental risk factors appears more likely. 2In the current study, Hammer et al. determined the IBD incidence of first-, second-and third-generation Faroese immigrants in Denmark relative to the risk in the local Danish population using linked population databases. 4 The Stan- that low-risk migrants over subsequent generations adopt the risk of the country to which they migrated. Consistent with the findings of the present study, our group also demonstrated an increased risk of IBD in migrants from a high incidence region, UK, to Canterbury, New Zealand where IBD incidence had previously been low. Interestingly, a significant adjusted association was seen for UC [1.4 (95% CI: 1.14-2.01)] but not for CD [1.38 (95% CI: 0.92-2.05)]. 7These observations highlight the importance of environmental exposures occurring early in life. A range of early life exposures have been shown to be associated with the subsequent development of IBD including having been breastfed, the early use of antibiotics and a range of markers of increased hygiene. However, some of these risk factors, such as the presence of a hot water tap in the home were only found to be associated with subsequent development of IBD in early studies.8 As such potential risk factors became ubiquitous, the ability to show their importance reduced.To determine the specific environmental factors that may lead to IBD, it is likely that researchers will need to characterise not just the environmental variables but also its timing of exposures to both cases and controls.9 Furthermore, the interaction of environmental factors with specific genotypes is also likely to identify genes that may only be important in IBD risk in the presence of specific environmental exposures. 10 In short, large cohorts of well genotyped, phenotyped and environmental exposure described cases and controls are likely to be needed to explore the role of the environment in the etio-pathogenesis of IBD.ACKNOWLEDGEMENT

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Section: Linked Contentsupporting

confidence: 72%

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confidence: 99%

Editorial: inflammatory bowel disease risk reduction after migration – are early life events important?

Lamba

Tharayil

Gearry

2017

Aliment Pharmacol Ther

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“…However, the same group found that although the incidence of CD had increased over time in both Europeans and South Asians, the incidence was significantly lower in South Asians as compared to Europeans [31] . In another migrant study, Benchimol et al [32] compared the incidence of IBD among immigrants and non-immigrants of Ontario, Canada, and found that the incidence of IBD among the immigrants was significantly lower that of the resident population (7.3/100,000 vs. 23.9/100,000). However, the incidence of IBD among the children of these immigrants was significantly higher than that of their parents and approached that of non-immigrants ( Fig.…”

Section: Migrant Epidemiologymentioning

confidence: 99%

Epidemiology of Inflammatory Bowel Disease in India: The Great Shift East

2017

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“…Nevertheless, it will be keen at creeping among those who, deliberately or forcefully, have left home behind, to face an abrupt encounter with a different (westernized) pattern of life. Such a scenario has recently been described (33) for thousands of North Africans or South American people, who moved to Canada. Following them up for a relatively short time, the investigators found that, by the second generation (at the latest), the risk of these immigrants to develop IBD matched the figures of the native Canadians.…”

Section: Diffusion Of Inflammatory Bowel Disease Among Immigrantsmentioning

confidence: 99%

The Changing Face of Inflammatory Bowel Disease: Etiology, Physiopathology, Epidemiology

Actis

2016

Ann Colorectal Res

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Context: The term inflammatory bowel disease (IBD) classically includes ulcerative colitis (UC) and Crohn's disease (CD). An abnormally increased mucosal permeability seems to underlie UC, whereas CD is thought to be the result of an immune deficiency state. Evidence Acquisition: While these phenomena may well be labeled as genetic factors, the environment has its role as well. Drugs (chiefly, antibiotics and non-steroidal anti-inflammatory molecules, with proton pump inhibitors recently joining the list) and smoking habits are all being scrutinized as IBD causative factors. Results: Once almost unknown, the prevalence of IBD, in the Eastern World and China, is now increasing by manifold, therefore arousing warning signals. Conclusions:A multidisciplinary approach will soon be necessary, to face the tenacious behavior of IBD, on a global perspective.

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Inflammatory Bowel Disease in Immigrants to Canada And Their Children: A Population-Based Cohort Study

Cited by 208 publications

References 21 publications

Editorial: inflammatory bowel disease risk reduction after migration – are early life events important?

Editorial: inflammatory bowel disease risk reduction after migration – are early life events important?

Epidemiology of Inflammatory Bowel Disease in India: The Great Shift East

The Changing Face of Inflammatory Bowel Disease: Etiology, Physiopathology, Epidemiology

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