Analysis of Inflammatory Bowel Disease-Associated Genetic Variants in a Healthy Manitoban First Nations Cohort

BACKGROUND: First Nation populations in Canada have a very low incidence of inflammatory bowel disease (IBD). Based on typical infections in this population, it is plausible that the First Nations react differently to microbial antigens with a different antibody response pattern, which may shed some light as to why they experience a low rate of IBD.OBJECTIVE: To compare the positivity rates of antibodies known to be associated with IBD in Canadian First Nations compared with a Canadian Caucasian population.METHODS: Subjects with Crohn’s disease, ulcerative colitis (UC), rheumatoid arthritis (RA) (as an immune disease control) and healthy controls without a personal or family history of chronic immune diseases, were enrolled in a cohort study aimed to determine differences between First Nations and Caucasians with IBD or RA. Serum from a random sample of these subjects (n=50 for each of First Nations with RA, First Nations controls, Caucasians with RA, Caucasians with Crohn’s disease, Caucasians with UC and Caucasians controls, and as many First Nations with either Crohn’s disease or UC as could be enrolled) was analyzed in the laboratory for the following antibodies: perinuclear antineutrophil cytoplasmic antibody (pANCA), and four Crohn’s disease-associated antibodies including anti-Saccharomyces cerevisiae, the outer membrane porin C ofEscherichia coli, I2 – a fragment of bacterial DNA associated withPseudomonas fluorescens, and the bacterial flagellin CBir-1. The rates of positive antibody responses and mean titres among positive results were compared.RESULTS: For pANCA, First Nations had a positivity rate of 55% in those with UC, 32% in healthy controls and 48% in those with RA. The pANCA positivity rate was 32% among Caucasians with RA. The rates of the Crohn’s disease-associated antibodies for the First Nations and Caucasians were comparable. Among First Nations, up to one in four healthy controls were positive for any one of the Crohn’s disease-associated antibodies. First Nations had significantly higher pANCA titres in both the UC and RA groups than CaucasiansDISCUSSION: Although First Nation populations experience a low rate of IBD, they are relatively responsive to this particular antibody panel.CONCLUSIONS: The positivity rates of these antibodies in First Nations, despite the low incidence of IBD in this population, suggest that these antibodies are unlikely to be of pathogenetic significance.

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Increasing Prevalence and Stable Incidence Rates of Inflammatory Bowel Disease Among First Nations: Population-Based Evidence From a Western Canadian Province

Inflammatory Bowel Diseases ◽

10.1093/ibd/izab096 ◽

2021 ◽

Author(s):

Juan Nicolás Peña-Sánchez ◽

Jessica Amankwah Osei ◽

Jose Diego Marques Santos ◽

Derek Jennings ◽

Mustafa Andkhoie ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

First Nations ◽

Indigenous Peoples ◽

Bowel Disease ◽

Population Based ◽

Incidence Rates ◽

Canadian Province ◽

Trends Over Time ◽

Inflammatory Bowel ◽

Over Time

Abstract Background There is limited to no evidence of the prevalence and incidence rates of inflammatory bowel disease (IBD) among Indigenous peoples. In partnership with Indigenous patients and family advocates, we aimed to estimate the prevalence, incidence, and trends over time of IBD among First Nations (FNs) since 1999 in the Western Canadian province of Saskatchewan. Methods We conducted a retrospective population-based study linking provincial administrative health data from the 1999-2000 to 2016-2017 fiscal years. An IBD case definition requiring multiple health care contacts was used. The prevalence and incidence data were modeled using generalized linear models and a negative binomial distribution. Models considered the effect of age groups, sex, diagnosis type (ulcerative colitis [UC], Crohn disease [CD]), and fiscal years to estimate prevalence and incidence rates and trends over time. Results The prevalence of IBD among FNs increased from 64/100,000 (95% confidence interval [CI], 62-66) in 1999-2000 to 142/100,000 (95% CI, 140-144) people in 2016-2017, with an annual average increase of 4.2% (95% CI, 3.2%-5.2%). Similarly, the prevalence of UC and CD, respectively, increased by 3.4% (95% CI, 2.3%-4.6%) and 4.1% (95% CI, 3.3%-4.9%) per year. In contrast, the incidence rates of IBD, UC, and CD among FNs depicted stable trends over time; no statistically significant changes were observed in the annual change trend tests. The ratio of UC to CD was 1.71. Conclusions We provided population-based evidence of the increasing prevalence and stable incidence rates of IBD among FNs. Further studies are needed in other regions to continue understanding the patterns of IBD among Indigenous peoples.

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Genetic variants in TNF-α but not DLG5 are associated with inflammatory bowel disease in a large United Kingdom cohort

Inflammatory Bowel Diseases ◽

10.1097/01.mib.0000217766.90766.37 ◽

2006 ◽

Vol 12 (3) ◽

pp. 178-184 ◽

Cited By ~ 30

Author(s):

Mark Tremelling ◽

Sarah Waller ◽

Francesca Bredin ◽

Simon Greenfield ◽

Miles Parkes

Keyword(s):

Inflammatory Bowel Disease ◽

United Kingdom ◽

Bowel Disease ◽

Genetic Variants ◽

Tnf Α ◽

Inflammatory Bowel

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124 Exome Analyses Identify Novel Inflammatory Bowel Disease-Associated Genetic Variants

Gastroenterology ◽

10.1016/s0016-5085(14)60119-0 ◽

2014 ◽

Vol 146 (5) ◽

pp. S-35

Author(s):

Dalin Li ◽

Jean-Paul Achkar ◽

Talin Haritunians ◽

Ken Hui ◽

Steven R. Brant ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Genetic Variants ◽

Inflammatory Bowel

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A4 A FRAMEWORK TO STUDY INFLAMMATORY BOWEL DISEASE AMONG INDIGENOUS PEOPLES AND PRELIMINARY RESULTS FROM SASKATCHEWAN, CANADA

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwz047.003 ◽

2020 ◽

Vol 3 (Supplement_1) ◽

pp. 5-6

Author(s):

J Peña-Sánchez ◽

D Jennings ◽

M Andkhoie ◽

C Brass ◽

G Bukassa-Kazadi ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

First Nations ◽

Indigenous Peoples ◽

Bowel Disease ◽

Research Team ◽

Incidence Rates ◽

Second Phase ◽

Care Providers ◽

Preliminary Results ◽

Inflammatory Bowel

Abstract Background Inflammatory Bowel Disease (IBD) is a chronic condition with significant life-threatening disease-related complications and reductions in quality of life if left untreated. Despite available research about IBD in the general population, there is limited-to-no evidence about IBD among Indigenous peoples in Canada and around the world. Aims We aimed to define a collaborative framework, estimate the prevalence and incidence rates of IBD among First Nations in Saskatchewan, Canada, and explore perceptions of IBD among Indigenous peoples in the province. Methods This study began when Indigenous patients shared their health experiences with IBD with research team members. An interdisciplinary research team was formed including Indigenous patient and family advocates (IPFAs, Indigenous patients living with IBD and parents of an Indigenous person with IBD), an IBD gastroenterologist, knowledge users, and Indigenous and non-Indigenous researchers. Our research team committed to raise awareness of IBD among Indigenous peoples within Indigenous communities and among health care providers and to advocate for better healthcare and well-being by providing evidence of IBD among Indigenous peoples living with IBD in Saskatchewan. We defined a mixed methodology. The first phase of the study used Saskatchewan administrative health data to estimate the prevalence and incidence rates with 95% confidence intervals (95%CI) of IBD among First Nations. The second phase of the study will use a photovoice methodology to gather “the voices” of Indigenous peoples with IBD, encouraging self-interpretation of pictures, engaging their communities, and empowering them with the study findings. Results The IPFAs play a critical role in the project by sharing their experiences and defining the directions of the project, as well as defining our research framework (Figure 1). Preliminary results show that the prevalence of IBD among First Nations in Saskatchewan increased from 66 (95%CI 65–68) per 100,000 population in 1999 to 148 (95%CI 145–151) per 100,000 people in 2015. In contrast, the incidence rates appear to be stable over time, 11/100,000 (95%CI 4–24) in 1999 and 11/100,000 (95%CI 5–20) in 2015. We started recruiting participants for the photovoice study in September 2019. Conclusions This ground-breaking patient-driven study is the first stage to improve health among Indigenous peoples living with IBD in Saskatchewan. This project will generate community-engaged knowledge and expertise to inform the development of an Indigenous IBD framework that could promote better and knowledge-based healthcare for Indigenous peoples with IBD in Canada and worldwide. Funding Agencies CIHRSaskatchewan Health Research Foundation (SHRF) and Saskatchewan Centre for Patient-Oriented Research (SCPOR)

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