Gewählte Publikation:
SHR
Neuro
Krebs
Kardio
Lipid
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Microb
Jüngst, C; Stadlbauer, V; Reichert, MC; Zimmer, V; Weber, SN; Ofner-Ziegenfuß, L; Voigtländer, T; Spindelböck, W; Fickert, P; Kirchner, GI; Lammert, F; Lankisch, TO; Krawczyk, M.
NOD2 gene variants confer risk for secondary sclerosing cholangitis in critically ill patients.
Sci Rep. 2017; 7(1):7026-7026
Doi: 10.1038/s41598-017-06268-y
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- Co-Autor*innen der Med Uni Graz
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Fickert Peter
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Ofner-Ziegenfuss Lisa
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Spindelböck Walter Johann
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Stadlbauer-Köllner Vanessa
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- Abstract:
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Sclerosing cholangitis in critically ill patients (SC-CIP) is a progressive cholestatic disease of unknown aetiology characterized by chronic biliary infections. Hence we hypothesized that common NOD2 (nucleotide-binding oligomerisation domain containing 2) gene variants, known risk factors for Crohn's disease and bacterial translocation in liver cirrhosis, increase the odds of developing SC-CIP. Screening of 4,641 endoscopic retrograde cholangiography procedures identified 17 patients with SC-CIP, who were then genotyped for the three common NOD2 mutations (Cohort 1, discovery cohort). To validate the association, we subsequently tested these NOD2 variants in 29 patients from SC-CIP cohorts of three additional medical centers (Cohort 2, replication cohort). In Cohort 1, the NOD2 variants were present in 5 of 17 SC-CIP patients (29.4%), which is twice the frequency of the general population. These results were replicated in Cohort 2 with 8 patients (27.6%) showing NOD2 mutations. In contrast, polymorphisms of hepatocanalicular transporter genes did not have major impact on SC-CIP risk. This first study on genetic susceptibility in SC-CIP patients shows an extraordinary high frequency of NOD2 variation, pointing to a critical role of inherited impaired anti-bacterial defense in the development of this devastating biliary disease.