Study shows epigenetic changes in children with Crohn's disease

A new study finds a wide range of epigenetic changes - alterations in DNA across the genome that may be related to key environmental exposures - in children with Crohn's disease (CD), reports Inflammatory Bowel Diseases, official journal of the Crohn's & Colitis Foundation of America (CCFA). The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

The study provides "compelling evidence" of alterations of DNA in several regions of the genome in children with CD, according to Professor Jack Satsangi of University of Edinburgh and colleagues. In addition to providing new insights into how genes and the environment interact, the results may have early implications for clinical management of CD.

Epigenetic Changes in Childhood-Onset Crohn's Disease

The researchers performed a "genome-wide" study in children with newly diagnosed CD, before any treatment, to look for possible epigenetic changes that may affect gene behavior. Epigenetic changes reflect the impact of a wide range of environmental factors on genes.

The results showed strong evidence of such changes at 65 different sites across the genome. Nineteen sites showed clustering of epigenetic changes, pointing at genetic pathways that might be relevant to CD development.

Similar patterns were present in a separate group of children who had been treated for CD, as well as in a group of treated adults.

Crohn's disease is a serious, chronic disease affecting the digestive system. Chronic means that the disease is long-term and persistent, usually lifelong. Crohn's disease causes inflammation, most often in the small intestine (which has three parts: duodenum, jejunum, and ileum). The walls and lining of the affected areas become red and inflamed, leading to ulcers and bleeding. Crohn's disease sometimes is named by referring to inflammation in the part of the intestine affected, such as jejunoileitis, ileitis, ileocolitis, or colitis (when it involves the large intestine, also called the colon).

Crohn's disease can appear at any age, but it is most often diagnosed in people between 13 and 30 years of age.

Along with ulcerative colitis, a similar illness, Crohn's disease is also called inflammatory bowel disease, or IBD. Ulcerative colitis attacks only the large intestine in a continuous manner and does not affect the entire thickness of the bowel wall. Crohn's disease, on the other hand, can occur anywhere in the digestive tract, from mouth to the anus, attacks different sites in the intestine with areas of normal intestine in between ("skip lesions"), and affects the full thickness of the intestinal wall. Both conditions wax and wane: there are times when symptoms reappear or get worse (exacerbations or "flares") and other periods when symptoms get better or go away altogether ("remission").

While Crohn's disease causes many problems for people of all ages, it can present special challenges for children and teens. In addition to bothersome and often painful symptoms, the disease can stunt growth, delay puberty, and weaken the bones. Crohn's disease symptoms may sometimes prevent a child from participating in enjoyable activities. The emotional and psychological issues of living with chronic disease can be especially difficult for young people.