Research ArticleCROHN’S DISEASE

Functional variants in the LRRK2 gene confer shared effects on risk for Crohn’s disease and Parkinson’s disease

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Science Translational Medicine  10 Jan 2018:
Vol. 10, Issue 423, eaai7795
DOI: 10.1126/scitranslmed.aai7795

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  • RE: Title: Two sides of the same coin. Both mutations and microbiota should be considered in diseases involving the ileum.
    • Bruno Donatini, gastroenterologist, Medicine Information Formation (research)

    Dear Editor,
    We have read the article entitled “Functional variants in the LRRK2 gene confer shared effects on risk for Crohn’s disease and Parkinson’s disease ” by Hui KY et al (Sci. Transl. Med. 10, eaai7795 (2018)). We want to congratulate the authors, and make some contributions.
    The conclusion states that, like in Parkinson’s disease (PD), variants of LRKK2 are associated with Crohn’s disease CD and mentions « a potential biological basis for clinical co-occurrence ».
    This sentence could puzzle clinicians who extremely rarely face patients with combined CD and PD and who know that these two groups of patients harbour different microbiota (1).
    In addition, the prevalence of Helicobacter pylori (HP) is low in CD and high in PD (2, 3). Gases measured with breath tests are specific and different between CD (4) and PD (5). Ulcerative colitis (UC), as opposed to CD, could be clinically associated with PD (6).
    Since the impact of microbiota may overcome the consequences of the mutations, a strong focus on genes could be misleading in clinical practice.

    Since the diagnosis of CD is sometimes difficult, since microbiota differ between ileum and colon, and since colonic CD is more and more considered as a specific disease (7), it could be valuable in further works to study confirmed CD (granuloma histologically confirmed) strictly limited to the small gut.
    It could also be of interest to investigate the presence or not of HP or other i...

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    Competing Interests: None declared.

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