The impact of smoking in Crohn's disease: no smoke without fire

Aldhous, Marian C.; Satsangi, Jack

doi:10.1136/fg.2010.001487

Cited by 11 publications

(15 citation statements)

References 118 publications

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“…One possible explanation is the high prevalence of ongoing active smoking in Cape Coloureds at study enrolment. Cigarette smoking is a well described risk factor for the development of complicated and aggressive CD over time [28]. The rate of complicated CD in our white subjects was lower compared to that described in other populations.…”

Section: Discussioncontrasting

confidence: 57%

The Association between Race and Crohn's Disease Phenotype in the Western Cape Population of South Africa, Defined by the Montreal Classification System

et al. 2014

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BackgroundInter-racial differences in disease characteristics and in the management of Crohn's disease (CD) have been described in African American and Asian subjects, however for the racial groups in South Africa, no such recent literature exists.MethodsA cross sectional study of all consecutive CD patients seen at 2 large inflammatory bowel disease (IBD) referral centers in the Western Cape, South Africa between September 2011 and January 2013 was performed. Numerous demographic and clinical variables at diagnosis and date of study enrolment were identified using an investigator administered questionnaire as well as clinical examination and patient case notes. Using predefined definitions, disease behavior was stratified as ‘complicated’ or ‘uncomplicated’.ResultsOne hundred and ninety four CD subjects were identified; 35 (18%) were white, 152 (78%) were Cape Coloured and 7(4%) were black. On multiple logistic regression analysis Cape Coloureds were significantly more likely to develop ‘complicated’ CD (60% vs. 9%, p = 0.023) during the disease course when compared to white subjects. In addition, significantly more white subjects had successfully discontinued cigarette smoking at study enrolment (31% vs. 7% reduction, p = 0.02). No additional inter-racial differences were found. A low proportion of IBD family history was observed among the non-white subjects.ConclusionsCape Coloured patients were significantly more likely to develop ‘complicated’ CD over time when compared to whites.

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Section: Discussioncontrasting

confidence: 57%

The Association between Race and Crohn's Disease Phenotype in the Western Cape Population of South Africa, Defined by the Montreal Classification System

et al. 2014

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“…Furthermore, smoking did not confound the relationship between 25(OH)D and disease activity, nor was it associated with vitamin D deficiency (20 or 29 ng/mL). This finding is not readily explainable given that smoking is a well-described risk factor for increased CD activity and severity [45] and that lower concentrations of 25(OH)D have been reported in patients with CD who smoke (compared to nonsmokers), independent of disease activity [12]. It is possible that a threshold exists in the amount smoked with regards to vitamin D status and disease activity, although evidence for this remains inconclusive [45][46][47][48].…”

Section: Discussionmentioning

confidence: 79%

Vitamin D Deficiency Increases the Risk for Moderate to Severe Disease Activity in Crohn's Disease Patients in South Africa, Measured by the Harvey Bradshaw Index

Basson

Swart²,

Jordaan

et al. 2015

Journal of the American College of Nutrition

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“…Several environmental factors such as appendectomy, dietary factors, domestic hygiene, oral contraceptive use, and childhood infections have been implicated in CD [17], but the most consistent epidemiological evidence points to a clear risk associated with cigarette smoking [18,19], which is the strongest environmental risk factor identified for CD to date [20]. Two meta-analyses reveal that current cigarette smokers are up to twice as likely to develop CD as non-smokers (OR = 1.8-2.0) [21,22].…”

Section: Introductionmentioning

confidence: 99%

A case-only study of gene-environment interaction between genetic susceptibility variants in NOD2 and cigarette smoking in Crohn's disease aetiology

et al. 2012

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BackgroundGenetic variation in NOD2 and cigarette smoking are well-established risk factors for the development of Crohn's disease (CD). However, little is known about a potential interaction between these risk factors. We investigated gene-environment interactions between CD-associated NOD2 alleles and cigarette smoking in a large sample of patients with CD.MethodsThree previously reported CD-associated variants in NOD2 (R702W, G908R, 1007fs) were genotyped in 1636 patients with CD continuously recruited between 1995 and 2010 based on physician referral. Data on history of smoking behaviour was obtained for all participants through a written questionnaire. Using a case-only design, we performed logistic regression analyses to investigate statistical interactions between NOD2 risk alleles and smoking status.ResultsWe detected a significant negative interaction between carriership of at least one of the NOD2 risk alleles and history of ever having smoked (OR = 0.71; p = 0.005) as well as smoking at the time of CD diagnosis (OR = 0.68; p = 0.005). Subsequent separate analyses of the three variants revealed a significant negative interaction between the 1007fs variant and history of ever having smoked (OR = 0.64; p = 9 × 10-4) and smoking at the time of CD diagnosis (OR = 0.53; p = 7 × 10-5).ConclusionsThe observed significant negative gene-environment interaction suggests that the risk increase for CD conferred simultaneously by cigarette smoking and the 1007fs NOD2 polymorphism is smaller than expected and may point to a biological interaction. Our findings warrant further investigation in epidemiological and functional studies to elucidate pathophysiology as well as to aid in the development of recommendations for disease prevention.

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The impact of smoking in Crohn's disease: no smoke without fire

Cited by 11 publications

References 118 publications

The Association between Race and Crohn's Disease Phenotype in the Western Cape Population of South Africa, Defined by the Montreal Classification System

The Association between Race and Crohn's Disease Phenotype in the Western Cape Population of South Africa, Defined by the Montreal Classification System

Vitamin D Deficiency Increases the Risk for Moderate to Severe Disease Activity in Crohn's Disease Patients in South Africa, Measured by the Harvey Bradshaw Index

A case-only study of gene-environment interaction between genetic susceptibility variants in NOD2 and cigarette smoking in Crohn's disease aetiology

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