Bactericidal permeability increasing protein (BPI)-ANCA — a marker of chronic inflammatory bowel diseases and inflammatory hepatobiliary diseases

There are many different rheumatic symptoms of gastrointestinal (GI) disorders and a whole range of GI symptoms that occur in rheumatologic disorders. Spondyloarthropathies (SpA) are closely related to the GI tract. Bacterial DNA has been detected in peripheral but not the sacroiliac joints of patients, including enterobacteria; the significance of this finding is not clear yet because antibiotic therapy seems not to be effective. The synovial lymphocyte proliferation of reactive arthritis (ReA) patients to the 60-kD heat-shock protein of Yersinia plays a major role in the immune response. Anti-Klebsiella antibodies are associated with gut lesions in SpA; their significance for the pathogenesis of SpA remains uncertain. ReA patients seem to have an impaired TH1-cytokine response, which might contribute to disease persistence. HLA B27-positive subjects seem to have a low tumor necrosis factor-alpha secretor status, possibly leading to diminished immune responses against certain microbes. In patients with Whipple's disease, Tropheryma whippelii can be cultured from gut biopsy specimens when interleukin-4 is added. The gene for hemochromatosis has been identified. Hepatitis C virus DNA can be found in many patients with cryoglobulinemia. Treatment with interferon-alpha might help in some patients. Effective treatment for primary biliary cirrhosis with ursodeoxycholic acid is not helpful for rheumatic symptoms. The severity of esophageal dysfunction in systemic sclerosis does not correlate with symptoms. GI symptoms do, although not frequently, occur in vasculitides.

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Sclerosing cholangitis associated with Wegener’s granulomatosis

Yüksel

Dağlı

Ataseven

et al. 2006

J of Gastro and Hepatol

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a prospective, double blind, randomized, clinical trial. Aliment. Pharmacol. Ther. 2003; 17: 211-16. 9 Sheu BS, Chi CH, Huang CC et al. Impact of intravenous omeprazole on Helicobacter pylori eradication by triple therapy in patients with peptic ulcer bleeding. Aliment. Pharmacol. Ther. 2002; 16: 137-43. 10 Duvnjak M, Supanc V, Troskot B et al. Comparison of intravenous pantoprazole with intravenous ranitidine in prevention of rebleeding from gastroduodenal ulcers. Gut 2001; 49 (Suppl. III): Abstract 2379. 11 Daneshmend TK, Hawkey CJ, Langman MJS et al. Omeprazole versus placebo for acute upper gastrointestinal bleeding: randomised double blind controlled trial. BMJ 1992; 304: 143-7. 12 Brunner G, Chang J. Intravenous therapy with high doses of ranitidine and omeprazole in critically ill patients with bleeding peptic ulcerations of the upper gastrointestinal tract: an open randomized controlled study. Digestion 1990; 45: 217-25. 13 Lin HJ, Lo WC, Lee FY et al. A prospective randomized comparative trial showing that omeprazole prevents rebleeding in patients with bleeding peptic ulcer after successful endoscopic therapy. Arch. Intern. Med. 1998; 158: 54-8. 14 Lau JY, Sung JJ, Lee KK et al. Effect of intravenous omeprazole on recurrent bleeding after endoscopic treatment of bleeding peptic ulcers. N. Eng. J. Med. 2000; 343: 310-16.

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Bactericidal permeability increasing protein (BPI)-ANCA — a marker of chronic inflammatory bowel diseases and inflammatory hepatobiliary diseases

Abstract: This study shows that BPI-ANCA is the third ANCA specificity, besides PR3-ANCA and MPO-ANCA, with a limited spectrum of clinical associations. The diagnostic and prognostic relevance of BPI-ANCA in the above clinical conditions is being examined prospectively.

Cited by 5 publications

References 24 publications

‘ANCA’ in liver diseases

‘ANCA’ in liver diseases

Rheumatologic manifestations of gastrointestinal disorders

Sclerosing cholangitis associated with Wegener’s granulomatosis

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