Background
Approximately one third to one half of children with chronic
granulomatous disease (CGD) develop gastrointestinal inflammation
characteristic of idiopathic inflammatory bowel disease (IBD), usually
Crohn’s disease (CD). We hypothesized that overall IBD genetic risk,
determined by IBD genetics risk score (GRS), might in part determine IBD
development in CGD.
Methods
We reviewed medical records to establish IBD diagnoses in CGD
subjects seen at NIAID. IBD risk SNP genotypes were determined using the
Immunochip and GRS were estimated by Mangrove.
Results
Among 157 Caucasian CGD patients 55 were confirmed, 78 excluded and
24 were uncertain for IBD. 201 established, independent European IBD risk
SNPs passed quality control. After sample quality control and removing non-IBD CGD patients with
perianal disease, mean GRS for 40 unrelated CGD-IBD patients was higher than
53 CGD non-IBD patients (in log2-scale 0.08±1.62 vs.
−0.67±1.64, p=0.026) but lower than 239 IBD Genetics
Consortium (IBDGC) young-onset CD cases (0.76±1.60, p=0.025). GRS
for non-IBD CGD was similar to 609 IBDGC controls
(−0.69±1.60, p=0.95). Seven established IBD SNPs were
nominally significant among CGD-IBD vs. CGD non-IBD, including those near
LACC1 (p=0.005), CXCL14 (p=0.007) and
TNFSF15 (p=0.016).
Conclusions
The weight of common IBD risk alleles are significant determinants of
IBD in CGD. However, IBD risk gene burden among CGD children with IBD is
significantly lower than that in non-syndromic pediatric CD, congruent with
the concept that defective superoxide production in CGD is also a major IBD
risk factor. Individual IBD genes might interact with the CGD defect to
cause IBD in CGD.