Étude des facteurs génétiques prédictifs de l’histoire naturelle postopératoire de la maladie de Crohn

Abstract : Crohn's disease occurs mainly in industrialized countries. In France it affects 1 person in 1000. The incidence is 5 per 100,000 persons per year. At present its pathogenesis remains poorly explained and many factors are involved (genetic, immunological and environmental). It seems essential to better understand Crohn's disease pathogenesis in order to identify therapeutic targets to improve its management and to identify predictors of postoperative recurrence and postoperative complications to customize the care of each patient. In this work we showed that a genetic variant of CARD8 (rs2043211) is a risk factor for postoperative recurrence. This combination is not influenced by the other known risk factors such as active smoking. Identifying CARD8 as a genetic risk factor for risk of surgical recurrence is of particular interest since it may become a novel therapeutic target for the treatment of Crohn's disease in the post-operative period. Our work has also shown that a genetic variant of NOD2 (rs5743289) is a risk factor for postoperative intraabdominal infectious complications (CIIP) after surgery in Crohn's disease. The identification of NOD2 gene as a risk factor for the occurrence of CIIP could establish an early stratification of patients at high risk for CIIP in whom surgery should be planned and predict patients at high risk for CIIP. Studies with large numbers replication cohort are still necessary before patients can enjoy the benefits of these tools in clinical practice
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Adeline Germain. Étude des facteurs génétiques prédictifs de l’histoire naturelle postopératoire de la maladie de Crohn. Médecine humaine et pathologie. Université de Lorraine, 2015. Français. ⟨NNT : 2015LORR0201⟩. ⟨tel-01754461⟩

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