Anti-Saccharomyces cerevisiae mannan antibodies combined with antineutrophil cytoplasmic autoantibodies in inflammatory bowel disease: prevalence and diagnostic role

Abstract

Background-Perinuclear antineutrophil cytoplasmic autoantibodies (pANCA) are a well recognised marker for ulcerative colitis. Antibodies to oligomannosidic epitopes of the yeast Saccharomyces cerevisiae (ASCA) are a new marker associated with Crohn's disease. Aims-To assess the value of detecting pANCA and/or ASCA for the diagnosis of ulcerative colitis and Crohn's disease. Methods-Serum samples were obtained from 100 patients with Crohn's disease, 101 patients with ulcerative colitis, 27 patients with other miscellaneous diarrhoeal illnesses, and 163 healthy controls. Determination of pANCA and ASCA was performed using the standardised indirect immunofluorescence technique and an ELISA, respectively. Results-The combination of a positive pANCA test and a negative ASCA test yielded a sensitivity, specificity, and positive predictive value of 57%, 97%, and 92.5% respectively for ulcerative colitis. The combination of a positive ASCA test and a negative pANCA test yielded a sensitivity, specificity, and positive predictive value of 49%, 97%, and 96% respectively for Crohn's disease. Among patients with miscellaneous non-inflammatory bowel disorders, three were ASCA positive and two were pANCA positive. One control was ASCA positive. The presence of ASCA in patients with Crohn's disease was associated with small bowel involvement. Conclusion-ASCA and pANCA are strongly associated with Crohn's disease and ulcerative colitis, respectively. Combination of both tests could help the diagnosis of inflammatory bowel disease. (Gut 1998;42:788-791)

Uric acid levels are independent of anti-Saccharomyces cerevisiae antibodies (ASCA) in Crohn’s disease: A reappraisal of the role of S. cerevisiae in this setting

“…In the present study, we once again confirmed what has been established over several decades about the prevalence and evolution of ASCA and associated phenotypes in CD, UC and healthy controls [3,8,13]. Interestingly, it has recently been shown that, besides CD, ASCA may also be associated with other diseases such as autoimmune diseases, including celiac disease [14] or physiological disorders[15] .…”

“…ASCA values in patients from the CD2 cohort were widely distributed with lower values corresponding to patients with a colonic location and/or older age at onset. Among the UC patients, only one was at the limit of significance of the test, in coherence with its initial indication for the differential diagnosis of the two forms of IBD [8]. Finally, the presence of ASCA in the non-IBD population (in the order of 6–7%) is consistent with that described previously[9].…”

“…In a second paper, we reported the interest of this test when combined with the detection of anti-neutrophil cytoplasmic antibodies (ANCA) for the differential diagnosis of CD vs. UC and designated the antibodies detected as ASCA [8] in order to confer homogeneity between acronyms of antibodies for differentiating the two forms of IBD. This was the first mention of the term ASCA in the literature.…”

Anti-Alpha-Enolase Antibody as a Serologic Marker and Its Correlation with Disease Severity in Intestinal Behçet’s Disease

“…Some antibodies are highly specific for UC or CD. For example, perinuclear antineutrophil cytoplasmic autoantibody (pANCA) is recognized as a marker of UC [4][5][6][7]. Anti-Saccharomyces cerevisiae antibody (ASCA) is useful as a highly specific serologic test for CD [5][6][7][8].…”

Diagnostic Value of the Serum Platelet-Activating Factor Acetylhydrolase Activity in Inflammatory Bowel Disease

“…As a result, a high positive predictive value (100%) would thus allow an accurate discrimination in 46% of the UC patients. In contrast to this, two of the most commonly used serologic markers for distinguishing UC from CD are perinuclear anti-neutrophil cytoplasmic antibody (pANCA) and anti-saccharomyces cerevisiae antibody (ASCA), which either alone or in combination demonstrated sensitivity, specificity, positive predictive values and negative predictive values ranging from 30% to 67%, 84% to 98%, 54% to 96%, and 41% to 86%, respectively (Quinton et al 1998;Koutroubakis et al 2001;Peeters et al 2001;Hisabe et al 2003;Lawrance et al 2004). Therefore, the serum PAF-AH activity may be a relatively more useful marker than ASCA and ANCA.…”