- Garcia-Etxebarria, Koldo;
- Zheng, Tenghao;
- Bonfiglio, Ferdinando;
- Bujanda, Luis;
- Dlugosz, Aldona;
- Lindberg, Greger;
- Schmidt, Peter T;
- Karling, Pontus;
- Ohlsson, Bodil;
- Simren, Magnus;
- Walter, Susanna;
- Nardone, Gerardo;
- Cuomo, Rosario;
- Usai-Satta, Paolo;
- Galeazzi, Francesca;
- Neri, Matteo;
- Portincasa, Piero;
- Bellini, Massimo;
- Barbara, Giovanni;
- Jonkers, Daisy;
- Eswaran, Shanti;
- Chey, William D;
- Kashyap, Purna;
- Chang, Lin;
- Mayer, Emeran A;
- Wouters, Mira M;
- Boeckxstaens, Guy;
- Camilleri, Michael;
- Franke, Andre;
- D’Amato, Mauro
Patients with irritable bowel syndrome (IBS) often associate their symptoms to certain foods. In congenital sucrase-isomaltase deficiency (CSID), recessive mutations in the SI gene (coding for the disaccharidase digesting sucrose and 60% of dietary starch)1 cause clinical features of IBS through colonic accumulation of undigested carbohydrates, triggering bowel symptoms.2 Hence, in a previous study,3 we hypothesized that CSID variants reducing SI enzymatic activity may contribute to development of IBS symptoms. We detected association with increased risk of IBS for 4 rare loss-of-function variants typically found in (homozygous) CSID patients, because carriers (heterozygous) of these rare variants were more common in patients than in controls.1,4 Through a 2-step computational and experimental strategy, the present study aimed to determine whether other (dys-)functional SI variants are associated with risk of IBS in addition to known CSID mutations. We first aimed to identify all SI rare pathogenic variants (SI-RPVs) on the basis of integrated Mendelian Clinically Applicable Pathogenicity (M-CAP) and Combined Annotation Dependent Depletion (CADD) predictive (clinically relevant) scores; next, we inspected genotype data currently available for 2207 IBS patients from a large ongoing project to compare SI-RPV case frequencies with ethnically matched population frequencies from the Exome Aggregation Consortium (ExAC).