title: Infectious serologies and autoantibodies in inflammatory bowel disease: insinuations at a true pathogenic role.
abstract: The aim of this study was to reevaluate the role of infection in inflammatory bowel disease (IBD). Sera from 119 patients with IBD [80 with Crohn's disease (CD); 39 with ulcerative colitis] and 98 healthy controls were assessed using the Bio-Rad BioPlex 2200 for the presence of Toxoplasma gondii, cytomegalovirus, Epstein-Barr virus, Treponema pallidum, and Saccharomyces cerevisiae. Hepatitis B virus, hepatitis C virus (HCV), and anti-Helicobacter pylori antibodies were assessed by ELISA. In addition, sera were tested for a panel of antibodies associated with thrombophilia as well as various autoantibodies. Titers of antibodies toward HCV and T. gondii, and S. cerevisiae were higher in IBD patients than in controls, while the H. pylori autoantibodies were less prevalent among the patient population. Several thrombophilia-associated antibodies were more common in CD patients, and a single patient had a thromboembolic event. Our results show an excess of anti-HCV and anti-T. gondii antibodies among patients with IBD compared to healthy controls. Whereas the former may be the result of immunosuppression from the inflammatory disease itself or from the medications used to treat it, the latter association suggests that T. gondii is involved in the etiopathogenesis of IBD, and especially CD, in humans, as has been shown in the murine model. However, our findings also reiterate the positive association between CD and anti-S. cerevisiae antibodies as well as the negative association with H. pylori infections. These, in turn, lend indirect support to the "hygiene hypothesis" in IBD as well as the newly proposed role of commensal bacteria in the initiation of the disease process.
authors.affiliation: Center for Autoimmune Disease, Rheumatology Unit, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Merav
authors.initials: M
authors.lastname: Lidar
authors.forename: Pnina
authors.initials: P
authors.lastname: Langevitz
authors.forename: Ori
authors.initials: O
authors.lastname: Barzilai
authors.forename: Maya
authors.initials: M
authors.lastname: Ram
authors.forename: Bat-Sheba
authors.initials: BS
authors.lastname: Porat-Katz
authors.forename: Nicola
authors.initials: N
authors.lastname: Bizzaro
authors.forename: Elio
authors.initials: E
authors.lastname: Tonutti
authors.forename: Roberto
authors.initials: R
authors.lastname: Maieron
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Chowers
authors.forename: Simon
authors.initials: S
authors.lastname: Bar-Meir
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Shoenfeld
mesh_terms: D000818:Animals; D000907:Antibodies, Bacterial / Q000097:blood*; D000908:Antibodies, Fungal / Q000097:blood; D000913:Antibodies, Protozoan / Q000097:blood*; D000914:Antibodies, Viral / Q000097:blood*; D001323:Autoantibodies / Q000097:blood*; D001424:Bacterial Infections / Q000097:blood / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D019204:GTP-Binding Proteins; D005903:Gliadin / Q000276:immunology; D016480:Helicobacter pylori / Q000276:immunology; D016174:Hepacivirus / Q000276:immunology; D006515:Hepatitis B virus / Q000276:immunology; D004854:Herpesvirus 4, Human / Q000276:immunology; D006801:Humans; D007118:Immunoassay / Q000379:methods; D015212:Inflammatory Bowel Diseases / Q000097:blood / Q000276:immunology*; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D012441:Saccharomyces cerevisiae / Q000276:immunology; D014122:Toxoplasma / Q000276:immunology; D014123:Toxoplasmosis / Q000097:blood / Q000276:immunology; D011503:Transglutaminases / Q000276:immunology; D014210:Treponema pallidum / Q000276:immunology; D014777:Virus Diseases / Q000097:blood / Q000276:immunology
chemical_list: D000907:Antibodies, Bacterial; D000908:Antibodies, Fungal; D000913:Antibodies, Protozoan; D000914:Antibodies, Viral; D001323:Autoantibodies; D005903:Gliadin; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins