title: Serum anti-glycan antibody biomarkers for inflammatory bowel disease diagnosis and progression: a systematic review and meta-analysis.
abstract: BACKGROUND
  Anti-glycan antibody serologic markers may serve as a useful adjunct in the diagnosis/prognosis of inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC). This meta-analysis/systemic review aimed to evaluate the diagnostic value, as well as the association of anti-glycan biomarkers with IBD susceptible gene variants, disease complications, and the need for surgery in IBD.
  
  
  METHODS
  The diagnostic odds ratio (DOR), 95% confidence interval (CI), and sensitivity/specificity were used to compare the diagnostic value of individual and combinations of anti-glycan markers and their association with disease course (complication and/or need for surgery).
  
  
  RESULTS
  Fourteen studies were included in the systemic review and nine in the meta-analysis. Individually, anti-Saccharomyces cervisiae antibodies (ASCA) had the highest DOR for differentiating IBD from healthy (DOR 21.1; 1.8-247.3; two studies), and CD from UC (DOR 10.2; CI 7.7-13.7; seven studies). For combination of ≥2 markers, the DOR was 2.8 (CI 2.2-3.6; two studies) for CD-related surgery, higher than any individual marker, while the DOR for differentiating CD from UC was 10.2 (CI 5.6-18.5; three studies) and for complication was 2.8 (CI 2.2-3.7; two studies), similar to individual markers.
  
  
  CONCLUSIONS
  ASCA had the highest diagnostic value among individual anti-glycan markers. While anti-chitobioside carbohydrate antibody (ACCA) had the highest association with complications, ASCA and ACCA associated equally with the need for surgery. Although in most individual studies the combination of ≥2 markers had a better diagnostic value as well as higher association with complications and need for surgery, we found the combination performing slightly better than any individual marker in our meta-analysis.
authors.affiliation: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.
authors.forename: Amit
authors.initials: A
authors.lastname: Kaul
authors.forename: Susan
authors.initials: S
authors.lastname: Hutfless
authors.forename: Ling
authors.initials: L
authors.lastname: Liu
authors.forename: Theodore M
authors.initials: TM
authors.lastname: Bayless
authors.forename: Michael R
authors.initials: MR
authors.lastname: Marohn
authors.forename: Xuhang
authors.initials: X
authors.lastname: Li
mesh_terms: D006801:Humans; D000888:Antibodies, Anti-Idiotypic / Q000097:blood; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D018450:Disease Progression; D015212:Inflammatory Bowel Diseases / Q000097:blood / Q000175:diagnosis; D011134:Polysaccharides / Q000037:antagonists & inhibitors / Q000276:immunology; D011379:Prognosis
chemical_list: D000888:Antibodies, Anti-Idiotypic; D015415:Biomarkers; D011134:Polysaccharides