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Crohn's Disease Forum » General IBD Discussion » Question about disease and Location


01-30-2013, 07:57 AM   #1
cleuger
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Question about disease and Location

I was looking at the map that's posted that says where your located and I'm wondering why most people with Bowel/Crohns disease is located in Easter US and Europe. Is it something were eating? or exposed to that no one else is. What is it? does anyone know?
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01-30-2013, 08:07 AM   #2
kiny
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There's theories why it's higher in the West (the rest of the world is catching up though). Here's the main ones I know. I agree with some and disagree with others, but I'm open to listening to all of the ones below since they are "reasonable" to me.

-Genetic predisposition, people in the West carry the NOD2 and ATG16L1 and IL23 gene mutation a lot which predisposes people to bacterial infection

-Hygiene theory, the cleaner your environment is, the less your adaptive immune system is capable of dealing with infections.

-Cold chain hypothesis, once you refridgerate food, you increase certain bacteria that thrive in a cold environment (listeria etc)

-Vitamin D theory, the more you live to the North, the less vitamin D you would get from the sun, low vitamin D status leaves your vulnerable to infections

-Zoonotic pathogen, a zoonotic bacteria would take time to spread, it would be localised in the West and spread further after time

-human-human infection

-Something in the food chain is causing dysbiosis which leaves people vulnerable to infections

There's some other theories but I don't think they make much sense.

Last edited by kiny; 01-30-2013 at 08:26 AM.
01-30-2013, 08:41 AM   #3
kiny
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Also, I think it's important to note that there are slight differnces between crohn's disease in Asia and the West.

Clinical differences exist, in Asia they have less complications, and the place of inflammation, while extremely similar is slightly different in Asia, one of either had more colon involvement that the other.

Genetic predisposition is different, in the West it's mainly Autophagy genes and predisposition to mycobacterial infection, in the East the main autophagy genes are not mutated, but they do carry the mycobacterial infection mutations.
01-30-2013, 10:07 AM   #4
LindaS
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I read a theory once that said it had something to do with predisposition and drinking cow's milk. In Asia, drinking milk is not common, but is slowly gaining in popularity.

I don't think they'll know why some populations have a higher incidence until the definitely figure out what causes Crohn's.
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01-30-2013, 07:31 PM   #5
cleuger
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There's theories why it's higher in the West (the rest of the world is catching up though). Here's the main ones I know. I agree with some and disagree with others, but I'm open to listening to all of the ones below since they are "reasonable" to me.

-Genetic predisposition, people in the West carry the NOD2 and ATG16L1 and IL23 gene mutation a lot which predisposes people to bacterial infection

-Hygiene theory, the cleaner your environment is, the less your adaptive immune system is capable of dealing with infections.

-Cold chain hypothesis, once you refridgerate food, you increase certain bacteria that thrive in a cold environment (listeria etc)

-Vitamin D theory, the more you live to the North, the less vitamin D you would get from the sun, low vitamin D status leaves your vulnerable to infections

-Zoonotic pathogen, a zoonotic bacteria would take time to spread, it would be localised in the West and spread further after time

-human-human infection

-Something in the food chain is causing dysbiosis which leaves people vulnerable to infections

There's some other theories but I don't think they make much sense.
So if I'm reading some of these theory's correctly I could have caused this myself?The Gene Theory I have no control over I'm trying to figure out Why me and looking at the map it seemed location has something to do with it. Ive thought about food additives and whether or not they could play a roll or not. Does everyone have these Genes? Sorry if that's a stupid question but I'm just asking. Does just a certain population carry the Gene?

Cindy
01-31-2013, 01:06 AM   #6
kiny
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So if I'm reading some of these theory's correctly I could have caused this myself?The Gene Theory I have no control over I'm trying to figure out Why me and looking at the map it seemed location has something to do with it. Ive thought about food additives and whether or not they could play a roll or not. Does everyone have these Genes? Sorry if that's a stupid question but I'm just asking. Does just a certain population carry the Gene?

Cindy
Not everyone with crohn's disease seems to have the same gene mutations. There are many people who run around with these gene mutations who do not have crohn's disease. Many people for example have the NOD2 mutation but do not have crohn's disease.

The genes related to crohn's disease are multiple, main ones are NOD2, ATG16L1, IL23, they are related to bacterial recognition and autophagy.

Other important ones are HLA-DR, CCDC122-LACC1 and RIPK2, they match leprosy susceptibility.

I think the gene research is important because it's pointing towards bacteria and how we deal with them (or fail to deal with them) through autophagy. Even if not everyone has these mutations, it's important to know them to find a cure.


I think it's best to compare this disease with diseases like leprosy or TB, since many of the susceptibility loci for them match crohn's disease.

-Not everyone gets Leprosy or TB.
-Certain genes make it far more likely that you wil get leprosy or TB, but they are not a requirement
-To actually get the disease you need a "trigger", in the form of the bacteria.

It's similar with crohn's disease, genes give people a predisposition, but it seems the genetic predisposition is not a requirement to get the disease.

I wouldn't say you caused this yourself, because we can't blame ourselves, we don't know the exact trigger so we had no idea how to prevent it.
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