Antinuclear antibodies: a marker associated with steroid dependence in patients with ulcerative colitis.
BACKGROUND
The autoimmune phenomena and the autoantibody profile have acquired great importance in ulcerative colitis (UC). Few studies have explored antinuclear antibodies (ANAs) prevalence, but not its association with steroid dependence. We hypothesized that ANAs could be a factor associated to steroid dependence.


METHODS
Ninety-seven consecutive patients with UC were included. ANA titers and staining patterns were determined by indirect immunofluorescence. Gender, age, follow-up time, C-reactive protein (CRP), disease extent, Mayo Score Activity Index, extraintestinal manifestations, and steroid dependence were analyzed in univariate and multivariate models.


RESULTS
Ninety-seven patients were included and 49 (50.5%) were females; mean age was 41.7 +/- 22.2 years. Positivity for ANAs was encountered in 52 (53.5%) patients, and none for anti-dsDNA. The prevalence of ANAs was higher in steroid-dependent than in nonsteroid-dependent patients (77.8% versus 48.1%, P = 0.020; odds ratio [OR] = 3.8, 95% confidence interval [CI] 1.1-12.5), and in those with uveitis (100% versus 51.1%; P = 0.040) or pyoderma gangrenosum (100% versus 51.6%; P = 0.078). No association was observed with gender, age, CRP, disease extent, and Mayo Score Activity Index. The multiple regression analysis model showed an association between steroid dependence and ANAs (P = 0.033, OR = 3.9, 95% CI 1.4-14.9).


CONCLUSIONS
ANAs are associated with steroid dependence in UC patients. Further studies are required to determine the role of ANAs as serological markers for prediction of steroid dependence in order to perform early therapeutic interventions with biological agents.
Barahona-Garrido
J
J
Inflammatory Bowel Disease Clinic, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Camacho-Escobedo
J
J
García-Martínez
C I
CI
Tocay
H
H
Cabiedes
J
J
Yamamoto-Furusho
J K
JK
D000328:Adult; D000974:Antibodies, Antinuclear / Q000097:blood* / Q000276:immunology*; D015415:Biomarkers / Q000097:blood; D003093:Colitis, Ulcerative / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology; D005260:Female; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011446:Prospective Studies; D017511:Pyoderma Gangrenosum / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology; D016036:Seroepidemiologic Studies; D013256:Steroids / Q000627:therapeutic use*; D014605:Uveitis / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology; D055815:Young Adult
D000974:Antibodies, Antinuclear; D015415:Biomarkers; D013256:Steroids