title: A new type of perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA) in active ulcerative colitis but not in Crohn's disease.
abstract: Sera of 64 patients with chronic inflammatory bowel disease (IBD) were screened for antibodies against neutrophil cytoplasmic antigens (ANCA) using an indirect immunofluorescence technique on ethanol-fixed human neutrophil granulocytes. 20 of 34 sera (59%) from patients with ulcerative colitis (UC) produced a fine-granular and perinuclear ANCA staining pattern (p-ANCA) clearly different from the typical diffuse and granular cytoplasmic ANCA fluorescence (c-ANCA, synonym ACPA) seen in active Wegener's granulomatosis (WG). The majority of the 20 p-ANCA positive UC patients had a high inflammatory disease activity. Among the 14 p-ANCA negative UC patients nine were without steroids; five of them had active disease, two were inactive and two had previously undergone colectomy. The remaining five patients still had active disease but received steroids for more than 4 weeks. Only 3 of the 30 sera from patients with Crohn's disease (CD) showed positive p-ANCA reactions. To narrow the specificity of the p-ANCA reaction all 64 sera were tested by ELISA for antibodies against anti-proteinase-3 (WG specific) and on HEp-2 cells for antinuclear (ANA) and anticytoplasmic antibodies. Ten p-ANCA positive UC sera were also tested in a myeloperoxidase ELISA. Only one UC serum reacted positively in the proteinase-3-ELISA and another one produced a weakly positive anti-nucleolar ANA fluorescence on HEp-2 cells. None of the tested sera reacted with myeloperoxidase suggesting that the p-ANCA staining pattern of granulocytes is not restricted to anti-myeloperoxidase antibodies as reported in the literature.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Dept. of Internal Medicine, University of Freiburg, Germany.
authors.forename: J A
authors.initials: JA
authors.lastname: Rump
authors.forename: J
authors.initials: J
authors.lastname: Schölmerich
authors.forename: V
authors.initials: V
authors.lastname: Gross
authors.forename: M
authors.initials: M
authors.lastname: Roth
authors.forename: R
authors.initials: R
authors.lastname: Helfesrieder
authors.forename: A
authors.initials: A
authors.lastname: Rautmann
authors.forename: J
authors.initials: J
authors.lastname: Lüdemann
authors.forename: W L
authors.initials: WL
authors.lastname: Gross
authors.forename: H H
authors.initials: HH
authors.lastname: Peter
mesh_terms: D000328:Adult; D019268:Antibodies, Antineutrophil Cytoplasmic; D000918:Antibody Specificity; D001323:Autoantibodies / Q000097:blood*; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000276:immunology*; D003424:Crohn Disease / Q000175:diagnosis / Q000276:immunology*; D003593:Cytoplasm / Q000276:immunology; D003937:Diagnosis, Differential; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D008297:Male; D009504:Neutrophils / Q000276:immunology
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D001323:Autoantibodies