Negative association between smoking and anti-saccharomyces cerevisiae antibodies in Crohn's disease.
BACKGROUND
Crohn's disease (CD) is a polygenic multifactorial heterogeneous disease. Anti-Saccharomyces Cerevisiae antibodies (ASCA) correlate highly with CD and are present in 50-80% of patients. The reason for ASCA positivity or negativity in CD is unknown. The aim of our work was to analyse clinical, epidemiological and genetic characteristics in ASCA+ or ASCA- CD patients.


METHODS
113 patients with CD were tested for ASCA (IgA and IgG) by using a commercial kit (Medipan Diagnostica). Age, gender, systemic manifestations, familial form of disease, age at diagnosis, location and behaviour of the disease, smoking habit as well as genotyping for -308 TNF gene polymorphisms were determined.


RESULTS
38.9% CD patients were negative for both IgA and IgG ASCA while 61.1% were ASCA positive (respectively IgA and IgG: 31.9%; IgA only: 9.7%; IgG only: 19.5%). The only significant difference between ASCA+ and ASCA- patients was for smoking habit: there were 29% smokers in ASCA+ versus 50% in ASCA- CD patients (P = 0.03). This low proportion of smokers was more prominent in ASCA IgA+ patients than in isolated ASCA IgG+ patients (25.6% versus 45.5%) and was minimal in patients with high titers of ASCA IgA (0/8). Logistic regression showed smoking habit still borderline for significance (P = 0.057).


CONCLUSIONS
Our results suggest a negative association between smoking and ASCA positivity in CD. This association was more prominent for ASCA IgA+. It indicates that smoking habit should be taken into account when analysing ASCA status in CD patients and may suggest an influence of smoking on immunization against intestinal material.
Van Kemseke
C
C
Department of Gastroenterology, Centre Hospitalier Universitaire de Liège, Domaine Universitaire du Sart Tilman, B35, 4000 Liège, Belgium. cvankemseke@chu.ulg.ac.be
Belaïche
J
J
Steeman
C
C
Louis
E
E
D000328:Adult; D000908:Antibodies, Fungal / Q000097:blood; D001530:Belgium; D003424:Crohn Disease / Q000453:epidemiology / Q000235:genetics / Q000276:immunology*; D005192:Family Health; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology; D007074:Immunoglobulin G / Q000276:immunology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012441:Saccharomyces cerevisiae / Q000276:immunology*; D012907:Smoking / Q000235:genetics / Q000276:immunology*; D013223:Statistics as Topic
D000908:Antibodies, Fungal; D007070:Immunoglobulin A; D007074:Immunoglobulin G