Antiglycan antibodies as serological markers in the differential diagnosis of inflammatory bowel disease.
BACKGROUND
The objective of the study was to evaluate the diagnostic accuracy of recently developed antiglycan serological tests in clinical practice for the diagnosis of Crohn's disease.


METHODS
This study was a cohort analysis of both clinical and biochemical parameters of patients with diagnosed inflammatory bowel disease compared with those in a control population. Antiglycan antibodies were determined using commercially available enzyme immunoassays. The setting was the outpatient unit of the gastroenterology department of a large, tertiary-care referral academic hospital. Participants were 214 consecutive patients, enrolled over a 5-month period, including 116 with Crohn's disease and 53 with ulcerative colitis, as well as 45 with other gastrointestinal diseases and 51 healthy controls.


RESULTS
Anti-Saccharomyces cerevisiae antibodies showed the best performance (54% sensitivity and 88%-95% specificity for Crohn's disease). Among patients with negative anti-Saccharomyces antibodies, 19 (34%) had high titers of at least another tested antiglycan antibody. Anti-Saccharomyces and anti-laminaribioside antibodies were associated with disease involving the small bowel and with penetrating or stricturing phenotype. Anti-laminaribioside was significantly higher in patients with a familial history of inflammatory bowel disease.


CONCLUSIONS
The new proposed serological markers are significantly associated with Crohn's disease, with low sensitivity but good specificity. About one third of anti-Saccharomyces-negative patients may be positive for at least 1 of those markers. Antiglycan antibodies appear to be associated with characteristic localization and phenotype of the disease.
Simondi
Daniele
D
Department of Gastrohepatology, San Giovanni Battista Hospital of Turin, Turin, Italy.
Mengozzi
Giulio
G
Betteto
Silvia
S
Bonardi
Renato
R
Ghignone
Roberta Patrizia
RP
Fagoonee
Sharmila
S
Pellicano
Rinaldo
R
Sguazzini
Carlo
C
Pagni
Roberto
R
Rizzetto
Mario
M
Astegiano
Marco
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000906:Antibodies / Q000097:blood* / Q000276:immunology; D000908:Antibodies, Fungal / Q000097:blood / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D015212:Inflammatory Bowel Diseases / Q000097:blood / Q000175:diagnosis* / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011134:Polysaccharides / Q000276:immunology*; D011446:Prospective Studies; D012372:ROC Curve; D012441:Saccharomyces cerevisiae / Q000276:immunology
D000906:Antibodies; D000908:Antibodies, Fungal; D015415:Biomarkers; D011134:Polysaccharides