Inflammatory Bowel Disease Clinical Trial
Official title:
Telomere Repair Gene Mutations in Inflammatory Bowel Disease
This study will evaluate and compare the genes of the telomere repair complex in healthy
control subjects, patients with blood diseases, and patients with inflammatory bowel disease
to identify what, if any, changes are associated specifically with inflammatory bowel
disease.
Patients between 2 and 80 years of age with ulcerative colitis or regional enteritis may be
eligible for this study. Participants are recruited from the practice of Dr. Stuart
Danovitch, Washington, D.C.
Researchers have established that minor differences in a specific set of genes called the
telomere repair complex are related to immune-mediated diseases of the bone marrow. NIH
researchers are now interested in whether inflammatory bowel disease and other autoimmune
diseases show a similar pattern of genetic differences.
Participants provide a cell sample for evaluation of the telomere repair complex. The sample
is collected via buccal swab, a gentle scraping of the inside of the cheek, and stored for
use in research.
We have identified inherited mutations in genes of the telomere repair complex in patients
with acquired aplastic anemia. These mutations diminish the ability of cells to repair the
ends of chromosomes, called telomeres, which normally shorten with each cell division.
Mutations in TERC, the gene which encodes for the RNA template of the complex; in TERT, the
gene for the enzyme in the complex, and also in the Schwachman-Bodian-Diamond syndrome gene
(SBDS), which we believe to be associated with telomere repair, lead to reduced telomerase
activity, diminished numbers of hematopoietic cells in the bone marrow, and presumably also a
deficiency in the ability of cells to respond to immunological attack and destruction of the
hematopoietic system.
This laboratory research protocol will allow us to evaluate whether similar gene mutations
might underlie other autoimmune diseases, here specifically, inflammatory bowel disease,
which share broad pathophysiologic features with immune-mediated aplastic anemia. We will
directly assess by DNA sequencing suspect genes (TERC, TERT, SBDS, DNA helicases and others)
in buccal mucosal samples obtained from patients with inflammatory bowel disease (IBD).
Analyses from large numbers of controls have defined polymorphisms for these genes. IBD
samples will allow us to determine whether mutations in these genes are more prevalent in
this patient population and to test the hypotheses that telomere repair defects underlie
human autoimmunity, or that these genes are specifically involved in hematology as risks
factors for bone marrow failure.
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