Infant colitis—it's in the genes

The online tool Polymorphism Phenotyping (Polyphen) predicted that the mutation might be damaging, and molecular modelling with Swiss PDB viewer indicated changes in the formation of hydrogen bonds that might affect the tertiary structure of interleukin-10 and its dimerisation (see webappendix figure 2). Despite the importance of interleukin-10 for intestinal immunity, in patients with Crohn's disease recombinant human interleukin-10 did not induce significant remission.3 The use of genetically modified bacteria (eg, Lactococcus spp) that secrete the human protein could be an attractive therapy option, but its efficacy in patients with interleukin-10 mutations remains unproven.4 Our clinical cases underline the importance of molecular diagnostics in modern clinical medicine.