We have shown that ELMO1 is more than just a director of phagocytosis17 and involved in the internalization of enteric bacteria and generation of intestinal inflammation18; ELMO1 is elevated in patients with inflammatory bowel disease and induces inflammatory cytokines19,20 ELMO1 regulates autophagy induction and bacterial clearance during infection with Salmonella21; ELMO1 interacts with microbial sensor NOD2 and together with mutant NOD2 associated with Crohn's disease (CD) are unable to clear CD-associated bacteria.22 This evidence concerns the gene ELMO1 and Cowden disease.