Anti-Saccharomyces cerevisiae antibodies (ASCA), phenotypes of IBD, and intestinal permeability: a study in IBD families.
BACKGROUND
Serologic markers anti-Saccharomyces cerevisiae antibodies (ASCA) and antineutrophil cytoplasmic antibodies with perinuclear staining (pANCA) have been proposed to study the immunopathogenesis of IBD. Their measurement may allow better phenotyping of the disease and the detection of subclinical disease.


OBJECTIVE
To test the hypothesis that serological markers identify an immunologic trait related to disease susceptibility. We also wanted to test the hypothesis that ASCA is a marker related to abnormal tissue permeation by common antigens.


METHODS
We studied the prevalence of pANCA and ASCA in a large cohort of sporadic and familial inflammatory bowel diseases and their unaffected relatives and spouses. Kinetics of ASCA was studied and the relationship between ASCA and 51Cr-EDTA intestinal permeation was investigated.


RESULTS
ASCA was associated with sporadic Crohn's disease (CD) (63%), with Crohn's patients belonging to pure CD families (62%) and also with their unaffected family members (21%). pANCA was associated with UC (58%). The prevalence of ASCA in CD patients belonging to mixed families was strikingly low (33%). ASCA was a stable marker throughout the disease and was not related to an increased small intestinal permeability.


CONCLUSIONS
ASCA is strongly associated with familial CD in Belgium, and 21% of healthy family members also display the marker. The association is much weaker in patients belonging to mixed families. ASCA is a stable marker and is not a secondary phenomenon due to increased intestinal permeability.
Gastroenterology Unit, UZ Gasthuisberg, Leuven, Belgium.
S
S
Vermeire
M
M
Peeters
R
R
Vlietinck
S
S
Joossens
E
E
Den Hond
V
V
Bulteel
X
X
Bossuyt
B
B
Geypens
P
P
Rutgeerts
D000293:Adolescent; D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000032:analysis*; D015415:Biomarkers / Q000032:analysis*; D002614:Chelating Agents; D002860:Chromium Radioisotopes; D015331:Cohort Studies; D004064:Digestive System / Q000276:immunology*; D004068:Digestive System Physiological Phenomena; D004492:Edetic Acid; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000235:genetics* / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D010375:Pedigree; D010539:Permeability; D010641:Phenotype; D012441:Saccharomyces cerevisiae / Q000276:immunology*
D000907:Antibodies, Bacterial; D015415:Biomarkers; D002614:Chelating Agents; D002860:Chromium Radioisotopes; D004492:Edetic Acid