title: High-level serum antibodies to bacterial antigens are associated with antibiotic-induced clinical remission in Crohn's disease: a pilot study.
abstract: In Crohn's disease, antibiotics are used with variable efficacy, suggesting that some patients are more likely to respond. The aim of this study was to determine whether Crohn's patients with predominant serum antibody reactivity toward bacterial antigens OmpC and/or I2 were more likely to achieve remission with antibiotics. Patients with ileal or ileal with right-sided colonic Crohn's disease were studied in a double-blind trial of budesonide alone or budesonide plus metronidazole and ciprofloxacin. In the budesonide plus metronidazole and ciprofloxacin group, patients with OmpC/I2 predominant profiles had the highest remission rate, whereas the group with no antibody predominant profiles had the lowest rate. In the budesonide group, patients with the OmpC/I2 predominant profile had the lowest remission rate, and the no-antibody group rate was higher. Although not statistically significant, these results support further testing to determine whether predominant serum reactivity to certain bacterial antigens may be a marker for efficacious use of antibiotics.
authors.affiliation: Inflammatory Bowel Disease Center, Division of Gastroenterology, Cedars-Sinai Medical Center and UCLA School of Medicine, Los Angeles, California 90048, USA.
authors.forename: William S
authors.initials: WS
authors.lastname: Mow
authors.forename: Carol J
authors.initials: CJ
authors.lastname: Landers
authors.forename: A Hillary
authors.initials: AH
authors.lastname: Steinhart
authors.forename: Brian G
authors.initials: BG
authors.lastname: Feagan
authors.forename: Ken
authors.initials: K
authors.lastname: Croitoru
authors.forename: Ernest
authors.initials: E
authors.lastname: Seidman
authors.forename: Gordon R
authors.initials: GR
authors.lastname: Greenberg
authors.forename: Stephan R
authors.initials: SR
authors.lastname: Targan
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood; D000942:Antigens, Bacterial / Q000276:immunology*; D019819:Budesonide / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000627:therapeutic use; D003424:Crohn Disease / Q000188:drug therapy / Q000276:immunology*; D004359:Drug Therapy, Combination; D006801:Humans; D008795:Metronidazole / Q000627:therapeutic use; D010865:Pilot Projects; D018272:Porins / Q000276:immunology*; D011551:Pseudomonas fluorescens / Q000276:immunology; D012074:Remission Induction; D018089:Superantigens / Q000097:blood*
chemical_list: D000890:Anti-Infective Agents; D019268:Antibodies, Antineutrophil Cytoplasmic; D000942:Antigens, Bacterial; C113724:OmpC protein; C469916:PfiT protein, Pseudomonas fluorescens; D018272:Porins; D018089:Superantigens; D008795:Metronidazole; D019819:Budesonide; D002939:Ciprofloxacin