English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Background  Influence of genetic variants in the  NOD2  gene may play a more important role in disease activity, behaviour and treatment of pediatric- than adult-onset Crohn’s disease (CD).    Methods  85 pediatric- and 117 adult-onset CD patients were tested for the three main  NOD2  CD-associated variants (p.R702W, p.G908R and p.10007fs) and clinical data of at least two years of follow-up were compared regarding disease behaviour and activity, response to therapy and bone mineral density (BMD).    Results  Chronic active and moderate to severe course of CD is associated in patients with pediatric-onset (p=0.0001) and  NOD2  variant alleles (p=0.0001). In pediatric-onset CD the average PCDAI-Score was significantly higher in patients carrying  NOD2  variants (p=0.0008). In addition, underweight during course of the disease (p=0.012) was associated with  NOD2  variants. Interestingly, osteoporosis was found more frequently in patients carrying  NOD2  variant alleles (p=0.033), especially in pediatric-onset CD patients with homozygous  NOD2  variants (p=0.037). Accordingly, low BMD in pediatric-onset CD is associated with a higher PCDAI (p=0.0092), chronic active disease (p=0.0148), underweight at diagnosis (p=0.0271) and during follow-up (p=0.0109). Furthermore, pediatric-onset CD patients with  NOD2  variants are more frequently steroid-dependent or refractory (p=0.048) and need long-term immunosuppressive therapy (p=0.0213).    Conclusions  These data suggests that the presence of any of the main  NOD2  variants in CD is associated with osteoporosis and an age of onset dependent influence towards underweight, higher disease activity and a more intensive immunosuppressive therapy. This observation supports the idea for an early intensive treatment strategy in children and adolescent CD patients with  NOD2  gene variants.

Age-of-onset-dependent influence of NOD2 gene variants on disease behaviour and treatment in Crohn’s disease