Cecile Libioulle, Edouard Louis, Sarah Hansoul, Cynthia Sandor, Frederic Farnir, Denis Franchimont, Severine Vermeire, Olivier Dewit, Martine de Vos, Anna Dixon, Bruno Demarche, Ivo Gut, Simon Heath, Mario Foglio, Liming Liang, Debby Laukens, Myriam Mni, Diana Zelenika, Andre Van Gossum, Paul Rutgeerts, Jacques Belaiche, Mark Lathrop, Michel Georges
To identify novel susceptibility loci for Crohn disease (CD), we undertook a genome-wide association study with more than 300,000 SNPs characterized in 547 patients and 928 controls. We found three chromosome regions that provided evidence of disease association with p-values between 106 and 109. Two of these (IL23R on Chromosome 1 and CARD15 on Chromosome 16) correspond to genes previously reported to be associated with CD. In addition, a 250-kb region of Chromosome 5p13.1 was found to contain multiple markers with strongly suggestive evidence of disease association (including four markers with p , 107). We replicated the results for 5p13.1 by studying 1,266 additional CD patients, 559 additional controls, and 428 trios. Significant evidence of association (p , 43104) was found in case/control comparisons with the replication data, while associated alleles were over-transmitted to affected offspring (p, 0.05), thus confirming that the 5p13.1 locus contributes to CD susceptibility.
The CD-associated 250-kb region was saturated with 111 SNP markers. Haplotype analysis supports a complex locus architecture with multiple variants contributing to disease susceptibility. The novel 5p13.1 CD locus is contained within a 1.25-Mb gene desert. We present evidence that disease-associated alleles correlate with quantitative expression levels of the prostaglandin receptor EP4, PTGER4, the gene that resides closest to the associated region. Our results identify a major new susceptibility locus for CD, and suggest that genetic variants associated with disease risk at this locus could modulate cis-acting regulatory elements of PTGER4.