A novel Smad7 genetic variant mapping on the genomic region targeted by mongersen is associated with Crohn's disease

Davide Di Fusco, Irene Marafini, Carmine Stolfi, Edoardo Troncone, Sara Onali, Elisabetta Lolli, Flavio Caprioli, Stefano Mazza, Cascella Raffaella, Laura Manzo, Paola Borgiani, Paolo Giuffrida, Antonio Di Sabatino, Ivan Monteleone, Giovanni Monteleone

Research output: Contribution to journalArticlepeer-review


Background: Down-regulation of Smad7 with a specific Smad7 antisense (AS) oligonucleotide-containing oral drug (Mongersen) was effiective in pre-clinical studies and initial clinical trials in Crohn's disease (CD) patients. A recent phase 3 trial was discontinued due to an apparent inefficacy of the drug, but factors contributing to the failure of this study remain unknown. Here, we analysed the frequency in CD of rs144204026 C/T single nucleotide polymorphism (SNP), which maps on the corresponding region targeted by the Smad7 AS contained in the Mongersen formulation and examined whether such a variant allele affects the ability of Smad7 AS to knockdown Smad7. Methods: rs144204026 SNP frequency was evaluated in two independent Italian cohorts of Crohn's disease patients and normal controls. Genotyping was performed by allelic discrimination assay. Smad7 expression was evaluated in wild-type or heterozygous PBMCs treated with Smad7 AS. Results: No TT genotype was seen in CD patients and controls. Heterozygous genotype was more frequent in CD patients of both cohort 1 (11/235, 4.68%) and cohort 2 (8/122, 6.56%) as compared to controls (6/363, 1.65%; p = 0.029 and p = 0.01 respectively). Overall, a statistically significant association was observed between the T variant allele and CD patients' susceptibility (p = 0.008; OR = 3.28, 95%CI: 1.3-8.3). Smad7 AS down-regulated Smad7 RNA independently of the presence of the variant allele. Conclusions: This is the first study to show an association between Smad7 rs144204026 SNP and CD patients. Data indicate that such a variant does not negatively influence the in vitro inhibitory effiect of Smad7 AS on Smad7.

Original languageEnglish
Article number234
Issue number8
Publication statusPublished - Aug 2020


  • Crohn's disease
  • Inflammatory bowel disease
  • Single nucleotide polymorphisms
  • Smad7
  • Ulcerative colitis

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Biochemistry, Genetics and Molecular Biology(all)


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