[Assessment of usefulness of anti-Saccharomyces cerevisiae and anti-neutrophil cytoplasmic antibodies in patients with unspecific inflammatory bowel diseases].
Ulcerative colitis (UC) and Crohn's disease (CD) are the nonspecific inflammatory bowel diseases with unknown etiology. Existing diagnostic methods are in many cases insufficient for proper diagnosis and choice of treatment method. In 10% cases of inflammatory bowel disease indeterminate colitis (IC) is described. It includes cases with diverse clinical manifestations, range and histopathological picture. New methods to distinguish inflammatory bowel diseases, chose proper treatment and monitor their activity are searched. Anti-Saccharomyces cerevisiae antibodies (ASCA) and antineutrophil cytoplasmatic antibodies (pANCA) seem to be a new markers used in this end.


OBJECTIVE
Comparison of ASCA and pANCA appearance in CD and UC searching of correlation between serum levels of antibodies, activity and clinical picture of disease and appearance of ASCA and pANCA in IC.


METHODS
We examined 63 patients with UC aged 24 to 74 (30 men and 33 women), 14 patients with CD aged 27 to 64 (10 men and 4 women) and 11 patients with IC aged 21 to 53 (4 men and 7 women). Mean duration time of diseases respectively for UC, CD and IC was 7.9 (from 1.0 to 32), 9 (from 1 to 20) and 3.04 (0.5 to 7) years. Diagnosis in specific clinical picture was established with endoscopic and histopathologic examination. Disease activity was described according to Rachmilewitz scale in UC and in CD according to Crohn's disease activity index (CDAI). Control group consisted of 24 healthy men. Examination of pANCA, IgA and IgG ACSA was performed with ELISA kits respectively by Congent Diagnostics and Genesis Diagnostic.


RESULTS
There were 39 of UC patients and of CD patients with active disease according to Rachmilewitz scale (above 3 points) and CDAI. We observed statistically more often pANCA in patients with UC (58%; n=31) than in patients with CD (28%; n=4) (p<0.05). Both IgA and IgG ACSCA occurred more often in patients with CD (57%; n=8) than in patients with UC (24%; n=15) (p<0.05). There were no significant differences between antibodies according to duration time, activity, location and treatment method of diseases. Obtained results besides the help with understanding of pathologic mechanisms, indicate for use of antibodies as an diagnostic tool in inflammatory bowel diseases.
Mokrowiecka
Anna
A
Klinika Chorób Przewodu Pokarmowego IMW UM w Lodzi. annazlo@poczta.wp.pl
Gasiorowska
Anita
A
Małecka-Panas
Ewa
E
D000328:Adult; D000368:Aged; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000276:immunology*; D000908:Antibodies, Fungal / Q000276:immunology; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000276:immunology; D003424:Crohn Disease / Q000175:diagnosis / Q000276:immunology; D003937:Diagnosis, Differential; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis* / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012441:Saccharomyces cerevisiae / Q000276:immunology*
D019268:Antibodies, Antineutrophil Cytoplasmic; D000908:Antibodies, Fungal; D007074:Immunoglobulin G