title: Higher titers of anti-Saccharomyces cerevisiae antibodies IgA and IgG are associated with more aggressive phenotypes in Romanian patients with Crohn's disease.
abstract: OBJECTIVE
  Serological markers have been widely used for diagnostic purposes and disease stratification in inflammatory bowel diseases (IBD). The aim of this study was to investigate the seroprevalence and the correlations of anti-Saccharomyces cerevisiae antibodies (ASCA) titers with different clinical phenotypes in Romanian patients with Crohn's disease (CD).
  
  
  METHODS
  The study included 107 CD and 86 ulcerative colitis (UC) patients from the Gastroenterology Departments of three University Hospitals, and 60 healthy subjects. ASCA IgA and IgG titers were determined using ELISA test. For CD patients the phenotype was established according to the Montreal classification. The differences in ASCA titers for different CD phenotypes were assessed using the Mann-Whitney U test.
  
  
  RESULTS
  ASCA prevalence was 33.6% in CD group, 12.8% in UC group and 6.6% in the control group. Significantly higher IgA (p=0.05) and IgG (p=0.03) titers were found in patients from the Montreal A1+A2 groups (age at onset below 40) compared with the older patients (A3). Higher titers were found in patients with extensive ileo-colonic lesions (L3) and upper gastrointestinal tract involvement (L4) than in patients having only colonic disease (L2). Significantly higher IgA (p=0.03) and IgG (p=0.03) titers were observed in patients with stenosing (B2) and penetrating (B3) disease compared with the nonstricturing, nonpenetrating (B1) phenotype. No correlation between ASCA titers and disease duration was found.
  
  
  CONCLUSIONS
  ASCA seropositivity in Romanian CD patients is lower than in Western Europe. Higher ASCA IgA and IgG titers are associated with a younger age at diagnosis and more aggressive phenotypes.
authors.affiliation: Department of Gastroenterology and Hepatology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: Serban
authors.initials: S
authors.lastname: Gologan
authors.forename: Razvan
authors.initials: R
authors.lastname: Iacob
authors.forename: Carmen
authors.initials: C
authors.lastname: Preda
authors.forename: Roxana
authors.initials: R
authors.lastname: Vadan
authors.forename: Bogdan
authors.initials: B
authors.lastname: Cotruta
authors.forename: Ana-Maria
authors.initials: AM
authors.lastname: Catuneanu
authors.forename: Speranta
authors.initials: S
authors.lastname: Iacob
authors.forename: Ileana
authors.initials: I
authors.lastname: Constantinescu
authors.forename: Liana
authors.initials: L
authors.lastname: Gheorghe
authors.forename: Silviu
authors.initials: S
authors.lastname: Iobagiu
authors.forename: Cristian
authors.initials: C
authors.lastname: Gheorghe
authors.forename: Mircea
authors.initials: M
authors.lastname: Diculescu
mesh_terms: D000293:Adolescent; D000328:Adult; D000908:Antibodies, Fungal / Q000097:blood*; D016022:Case-Control Studies; D003093:Colitis, Ulcerative / Q000276:immunology* / Q000382:microbiology / Q000473:pathology; D003424:Crohn Disease / Q000276:immunology* / Q000382:microbiology / Q000473:pathology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood*; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D012383:Romania; D012441:Saccharomyces cerevisiae / Q000276:immunology*; D016036:Seroepidemiologic Studies; D055815:Young Adult
chemical_list: D000908:Antibodies, Fungal; D007070:Immunoglobulin A; D007074:Immunoglobulin G