Significance of anti-sacharomices cerevisiae antibodies (ASCA) in patients with inflammatory bowel diseases in Romania.
BACKGROUND
Anti-Sacharomyces cerevisiae antibodies (ASCA) represent the immunologic marker correlated with Crohn's disease because of their high specificity (80-95%). The aim of this study is to confirm their value in a Romanian population with IBD.


METHODS
A prospective longitudinal study was performed, which included patients admitted to Center of Gastroenterology and Hepatology Fundeni, Bucharest, in 2000 with ulcerative colitis (33 patients) - UC group, or Crohn's disease (40 patients) - CD group, and a control group (C) consisting of 22 healthy subjects. ASCA determination from serum samples was performed in the Erasmus University by ELISA technique.


RESULTS
ASCA+ prevalence in CD group was 5 in 40 patients (12.5%), in UC group 0/33 (0%), 1/21 C group (4.9%), p=0.05. ASCA+ phenotype was found only in patients with CD diagnosed before the age of 40 years (A1), p=0.04. Also, ASCA+ phenotype correlated significantly with the colonic (L2) or ileocolonic (L3) extension (p=0.05). ASCA+ status did not correlate with the evolutive pattern of CD (stricturing, penetrating or non- stricturing non-penetrating), and neither did the clinical severity.


CONCLUSIONS
ASCA+ prevalence in CD patients is much lower compared with North-American or West-European studies (12.5% versus 40-70%). In Romanian patients, ASCA assessment may be helpful in achieving a diagnosis of Crohn's disease, especially in those younger than 40 years, or in those with colonic or ileocolonic extension.
Preda
Carmen Monica
CM
Center of Gastroenterology and Hepatology, Fundeni Clinical Institute, Str. Fundeni no. 258, 72437 Bucharest, Romania. preda.carmen@email.ro
Diculescu
Mircea
M
Mirea
Virginia
V
Marica
Catalin
C
Vermeire
Severine
S
Rutgeerts
Paul
P
Oproiu
Alexandru
A
D000328:Adult; D000908:Antibodies, Fungal / Q000032:analysis*; D016022:Case-Control Studies; D003093:Colitis, Ulcerative / Q000276:immunology* / Q000382:microbiology*; D003424:Crohn Disease / Q000276:immunology* / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D011446:Prospective Studies; D012383:Romania; D012441:Saccharomyces cerevisiae / Q000276:immunology* / Q000472:pathogenicity*; D012680:Sensitivity and Specificity; D016036:Seroepidemiologic Studies
D000908:Antibodies, Fungal