New serological markers in inflammatory bowel disease are associated with complicated disease behaviour.
OBJECTIVE
Several antibodies have been associated with Crohn's disease and are associated with distinct clinical phenotypes. The aim of this study was to determine whether a panel of new antibodies against bacterial peptides and glycans could help in differentiating inflammatory bowel disease (IBD), and whether they were associated with particular clinical manifestations.


METHODS
Antibodies against a mannan epitope of Saccharomyces cerevisiae (gASCA), laminaribioside (ALCA), chitobioside (ACCA), mannobioside (AMCA), outer membrane porins (Omp) and the atypical perinuclear antineutrophilic cytoplasmic antibody (pANCA) were tested in serum samples of 1225 IBD patients, 200 healthy controls and 113 patients with non-IBD gastrointestinal inflammation. Antibody responses were correlated with the type of disease and clinical characteristics.


RESULTS
76% of Crohn's disease patients had at least one of the tested antibodies. For differentiation between Crohn's disease and ulcerative colitis, the combination of gASCA and pANCA was most accurate. For differentiation between IBD, healthy controls and non-IBD gastrointestinal inflammation, the combination of gASCA, pANCA and ALCA had the best accuracy. Increasing amounts and levels of antibody responses against gASCA, ALCA, ACCA, AMCA and Omp were associated with more complicated disease behaviour (44.7% versus 53.6% versus 71.1% versus 82.0%, p < 0.001), and a higher frequency of Crohn's disease-related abdominal surgery (38.5% versus 48.8% versus 60.7% versus 75.4%, p < 0.001).


CONCLUSIONS
Using this new panel of serological markers, the number and magnitude of immune responses to different microbial antigens were shown to be associated with the severity of the disease. With regard to the predictive role of serological markers, further prospective longitudinal studies are necessary.
Ferrante
Marc
M
Department of Gastroenterology, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium.
Henckaerts
Liesbet
L
Joossens
Marie
M
Pierik
Marie
M
Joossens
Sofie
S
Dotan
Nir
N
Norman
Gary L
GL
Altstock
Rom T
RT
Van Steen
Kristel
K
Rutgeerts
Paul
P
Van Assche
Gert
G
Vermeire
Séverine
S
D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood*; D000908:Antibodies, Fungal / Q000097:blood*; D000942:Antigens, Bacterial / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000382:microbiology / Q000473:pathology; D003424:Crohn Disease / Q000175:diagnosis / Q000382:microbiology / Q000473:pathology; D003937:Diagnosis, Differential; D004812:Epidemiologic Methods; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D008875:Middle Aged; D012441:Saccharomyces cerevisiae / Q000276:immunology
D000907:Antibodies, Bacterial; D000908:Antibodies, Fungal; D000942:Antigens, Bacterial; D015415:Biomarkers