title: Association of Anti-glycan Antibodies and Inflammatory Bowel Disease Course.
abstract: OBJECTIVE
  The usefulness of anti-glycan antibodies alone or combined with anti-Saccharomyces cerevisiae [ASCA] or perinuclear antineutrophil cytoplasmic [pANCA] antibodies for diagnosis of inflammatory bowel disease [IBD], differentiation between Crohn's disease [CD] and ulcerative colitis [UC], disease stratification including IBD phenotype, and also for determination of the course of the disease, remain unclear.
  
  
  METHODS
  A large panel of serological anti-glycan carbohydrate antibodies, including anti-mannobioside IgG antibodies [AMCA], anti-chitobioside IgA [ACCA], anti-laminaribioside IgG antibodies [ALCA], anti-laminarin [anti-L] and anti-chitine [anti-C] were measured in the serum from a cohort of 195 patients with IBD] [107 CD and 88 UC]. The respective accuracy of isolated or combined markers for diagnosis, disease differentiation, stratification disease phenotype, and severity of the disease course, defined by a wide panel of criteria obtained from the past medical history, was assessed.
  
  
  RESULTS
  The positivity of at least one anti-glycan antibody was detected in a significant higher proportion of CD and UC compared with healthy controls [p < 0.0001 and p < 0.0007, respectively]. Whereas ASCA and ANCA antibody status had the highest efficacy to be associated with CD in comparison with UC (area under receiver operating characteristic curve [AUROC] = 0.70 for each], the adjunction of anti-laminarin antibody substantially improved the differentiation between CD and UC [AUROC = 0.77]. Titres of ACCA [> 51U/ml] and anti-laminarin [> 31U/ml] were significantly linked with a higher association with steroid dependency (odds ratio [OR] =2.0 [1.0-4.0], p = 0.03 and OR = 2.4 [1.1-5.2], p = 0.02, respectively]. We further defined the respective performance of anti-glycan antibodies to discriminate between patients with severe or not severe CD and UC course and determined the associated optimal cut-off values: severe CD course was significantly more likely in case of AMCA > 77U/ml [OR = 4.3; p = 0.002], ASCA > 63U/ml [OR = 3.5; p < 0.009] and at a lesser degree ACCA > 50U/ml [OR = 2.8; p < 0.02] and severe UC course was significantly associated with AMCA > 52U/ml [OR = 3.4; p = 0.04] and ACCA > 25U/ml [OR = 3.0; p < 0.04].
  
  
  CONCLUSIONS
  Anti-glycan antibodies are valuable serological markers, especially AMCA antibodies that may help clinicians to promptly classify patients into high risk for severe disease.
authors.affiliation: Laboratory of Immunology, University Hospital, Saint-Etienne, France.
authors.forename: S
authors.initials: S
authors.lastname: Paul
authors.affiliation: Department of Gastroenterology, Lyon-Sud Hospital, Pierre-Benite, France and International Centre for Research in Infectiology [CIRI], Lyon, France.
authors.forename: G
authors.initials: G
authors.lastname: Boschetti
authors.affiliation: Laboratory of Immunology, University Hospital, Saint-Etienne, France.
authors.forename: M
authors.initials: M
authors.lastname: Rinaudo-Gaujous
authors.affiliation: Laboratory of Immunology, University Hospital, Saint-Etienne, France.
authors.forename: A
authors.initials: A
authors.lastname: Moreau
authors.affiliation: Department of Gastroenterology, University Hospital, Saint-Etienne, France.
authors.forename: E
authors.initials: E
authors.lastname: Del Tedesco
authors.affiliation: Laboratory of Immunology, University Hospital, Saint-Etienne, France.
authors.forename: J
authors.initials: J
authors.lastname: Bonneau
authors.affiliation: DRCI-CIC, University Hospital, Saint-Etienne, France.
authors.forename: E
authors.initials: E
authors.lastname: Presles
authors.affiliation: Pharmacy Department, University Hospital, Saint-Etienne, France.
authors.forename: F
authors.initials: F
authors.lastname: Mounsef
authors.affiliation: Department of Gastroenterology, University Hospital, Saint-Etienne, France.
authors.forename: L
authors.initials: L
authors.lastname: Clavel
authors.affiliation: Laboratory of Immunology, University Hospital, Saint-Etienne, France.
authors.forename: C
authors.initials: C
authors.lastname: Genin
authors.affiliation: Department of Gastroenterology, Lyon-Sud Hospital, Pierre-Benite, France and International Centre for Research in Infectiology [CIRI], Lyon, France.
authors.forename: B
authors.initials: B
authors.lastname: Flourié
authors.affiliation: Department of Gastroenterology, University Hospital, Saint-Etienne, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Phelip
authors.affiliation: Department of Gastroenterology, Lyon-Sud Hospital, Pierre-Benite, France and International Centre for Research in Infectiology [CIRI], Lyon, France.
authors.forename: S
authors.initials: S
authors.lastname: Nancey
authors.affiliation: Department of Gastroenterology, University Hospital, Saint-Etienne, France xavier.roblin@chu-st-etienne.fr.
authors.forename: X
authors.initials: X
authors.lastname: Roblin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood*; D000908:Antibodies, Fungal / Q000097:blood*; D019540:Area Under Curve; D003093:Colitis, Ulcerative / Q000097:blood / Q000175:diagnosis*; D003424:Crohn Disease / Q000097:blood / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D005936:Glucans / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011134:Polysaccharides / Q000276:immunology*; D011446:Prospective Studies; D012372:ROC Curve; D012441:Saccharomyces cerevisiae / Q000276:immunology*; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D000908:Antibodies, Fungal; D005936:Glucans; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D011134:Polysaccharides; C008247:laminaran
keywords: Crohn’s disease; IBD behaviour; Serological antibodies; anti-glycans; ulcerative colitis