title: Serum anti-glycan antibodies predict complicated Crohn's disease behavior: a cohort study.
abstract: BACKGROUND
  A high proportion of patients with Crohn's disease (CD) over time develop complications like fistulae and strictures, requiring surgery. We tested a panel of antiglycan antibodies for predicting the occurrence of complications and CD-related surgery in an adult patient cohort.
  
  
  METHODS
  Serum samples of 149 CD patients of the German inflammatory bowel disease (IBD) network were tested for the presence of anti-laminarin IgA (Anti-L), anti-chitin IgA (Anti-C), anti-chitobioside IgA (ACCA), anti-laminaribioside IgG (ALCA), anti-mannobioside IgG (AMCA), and anti-Saccaromyces cerevisiae IgG (gASCA) carbohydrate antibodies by enzyme-linked immunosorbent assay (ELISA) (IBDX(R) panel, Glycominds, Lod, Israel) in a blinded fashion. Clinical data were available on occurrence of complicated disease or CD-related surgery as well as disease activity, onset, and location.
  
  
  RESULTS
  The median follow-up of the patients without any previous complication or surgery at time of sample procurement was 53.7 months. Overall, 26.3% developed a complication and 17.1% underwent CD-related surgery, respectively. Positivity for gASCA, AMCA, ACCA, and Anti-L alone or an increasing frequency of positive serum antibodies independently predicted a faster progression toward a more severe disease course. Once a complication or surgery had occurred only positivity for Anti-L or more than 3 markers out of the whole panel indicated progression to an additional surgery or complication. The antibody status of most patients remained stable over time.
  
  
  CONCLUSIONS
  This is the first study showing the clinical value of serum antiglycan antibodies for prediction of a more complicated disease course in adult patients with CD.
authors.affiliation: Department of Internal Medicine I, University of Regensburg, Regensburg, Germany. florian.rieder@t-online.de
authors.forename: Florian
authors.initials: F
authors.lastname: Rieder
authors.forename: Stephan
authors.initials: S
authors.lastname: Schleder
authors.forename: Alexandra
authors.initials: A
authors.lastname: Wolf
authors.forename: Andrea
authors.initials: A
authors.lastname: Dirmeier
authors.forename: Ulrike
authors.initials: U
authors.lastname: Strauch
authors.forename: Florian
authors.initials: F
authors.lastname: Obermeier
authors.forename: Rocio
authors.initials: R
authors.lastname: Lopez
authors.forename: Larissa
authors.initials: L
authors.lastname: Spector
authors.forename: Ella
authors.initials: E
authors.lastname: Fire
authors.forename: Jennifer
authors.initials: J
authors.lastname: Yarden
authors.forename: Gerhard
authors.initials: G
authors.lastname: Rogler
authors.forename: Nir
authors.initials: N
authors.lastname: Dotan
authors.forename: Frank
authors.initials: F
authors.lastname: Klebl
mesh_terms: D000328:Adult; D000906:Antibodies / Q000097:blood*; D002686:Chitin / Q000276:immunology; D015331:Cohort Studies; D003424:Crohn Disease / Q000097:blood / Q000150:complications* / Q000276:immunology* / Q000601:surgery; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005936:Glucans; D006801:Humans; D008297:Male; D011134:Polysaccharides / Q000276:immunology*; D011237:Predictive Value of Tests; D011446:Prospective Studies
chemical_list: D000906:Antibodies; D005936:Glucans; D011134:Polysaccharides; D002686:Chitin; C008247:laminaran