Further examples are the autophagy gene autophagy-related 16-like 1 (Atg16L1) that plays an important role in CD pathogenesis by affecting Paneth cell granule exocytosis in patients with an ileal phenotype (22) or the transcription factor X-box binding protein 1 (XBP1) of the endoplasmic reticulum stress response activated during an inflammation. This evidence concerns the gene XBP1 and Cowden disease.