Diagnostic role and clinical correlates of anti-Saccharomyces cerevisiae antibodies (ASCA) and anti-neutrophil cytoplasmic antibodies (p-ANCA) in Italian patients with inflammatory bowel diseases

Saibeni, Simone; Folli, Christian; Franchis, Roberto de; Borsi, G; Vecchi, Maurizio

doi:10.1016/j.dld.2003.07.001

Cited by 35 publications

(35 citation statements)

References 37 publications

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“…The presence of serum perinuclear anti-neutrophil cytoplasmic antibody (pANCA) was reported in 59-84% of patients with UC in the 1990s [4,5], and, since then, many studies have demonstrated an association between pANCA and UC. Although the antibody does not appear to play a pathologic role in inflammatory bowel disease (IBD) [6], its possible clinical significance as a noninvasive diagnostic tool has been proposed. However, in contrast to systemic vasculitides in which the presence and titers of pANCA are related to disease activity and can be used as diagnostic and prognostic tools [7], there are conflicting results on the relationship between pANCA and disease activity or the clinical course of UC.…”

Section: Introductionmentioning

confidence: 99%

The Prevalence and Clinical Significance of Perinuclear Anti-neutrophil Cytoplasmic Antibody in Korean Patients with Ulcerative Colitis

et al. 2009

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Perinuclear anti-neutrophil cytoplasmic antibody (pANCA) is a serological marker associated with various immune-mediated diseases whose clinical significance and possible diagnostic roles in ulcerative colitis (UC) are still unclear. We aimed to evaluate the prevalence of pANCA expression and its association with clinical findings and disease course in Korean patients with UC. This study included 484 patients with UC who were diagnosed and treated between 1990 and 2006 at Severance Hospital, Yonsei University, Seoul, Korea, and were followed for at least 1 year. Clinical findings at diagnosis, disease extent, treatment modalities used, and cumulative relapse rates were analyzed and compared to pANCA expression. Of the 484 patients, 405 (83.7%) were evaluated for pANCA and were eligible for analysis. The overall pANCA prevalence was 22.1%, with a female preponderance (male, 21.5%; female, 31.6%; P < 0.05). Proctitis was more common in pANCA-negative patients (pANCA-negative, 37.6%; pANCA-positive, 25.2%, P < 0.05). UC activity index and cumulative relapse rates were higher in pANCA-positive patients. However, there were no significant differences in the cumulative probability of steroid and immunosuppressant use and operation rate between the two groups. The prevalence of pANCA expression in Korean patients with UC was relatively low compared to that in Western countries. Although UC patients with pANCA expression had more severe clinical findings at diagnosis and higher cumulative relapse rates in our study, further prospective studies are warranted to clarify whether pANCA positivity influences the initial clinical presentation or disease aggressiveness.

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Section: Introductionmentioning

confidence: 99%

The Prevalence and Clinical Significance of Perinuclear Anti-neutrophil Cytoplasmic Antibody in Korean Patients with Ulcerative Colitis

et al. 2009

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“…ASCA IgG is found in 50 to 80% of CD patients but only 20% of UC patients. Multiple studies have reported the simultaneous presence of ASCA IgA and IgG to be highly specific for CD (3,31,33). ASCA antibodies are currently identified using commercial or in-house-developed EIAs.…”

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confidence: 99%

Analysis of Serum Antibodies in Patients Suspected of Having Inflammatory Bowel Disease

Jaskowski

Litwin

Hill

2006

Clin Vaccine Immunol

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Inflammatory bowel disease (IBD) is the general term used for a heterogeneous group of intestinal disorders, including Crohn's disease (CD) and ulcerative colitis (UC). Serological markers such as anti-Saccharomyces cerevisiae antibodies (ASCA) and atypical perinuclear antineutrophilic cytoplasmic antibody (atypical pANCA) have proven useful in the diagnosis and differentiation of CD and UC. Immunoglobulin A (IgA) antibody directed against the outer membrane protein C (OmpC) of Escherichia coli is said by one group to have clinical utility in diagnosing IBD, specifically in ASCA-negative CD patients. Our objective in this study was to compare the results obtained from two separate laboratories offering similar IBD tests using sera from suspected IBD patients. One hundred ninety-seven sera received for IBD testing were included in the study. The agreement between the two laboratories was 93.4% for ASCA IgA, 90.9% for ASCA IgG, and 87.8% for atypical pANCA IgG. There were 25 sera with ASCA-negative/OmpC-positive results reported by one laboratory. Thirteen of these 25 (52.0%) ASCA-negative/OmpC-positive sera were also atypical pANCA positive (9 as determined by both laboratories, 3 by one, and 1 by the other). Atypical pANCA antibody is found primarily in IBD patients with UC and colon-limited CD (Crohn's colitis). We conclude that the ASCA and atypical pANCA assays showed good agreement between the two laboratories, but the data for ASCA-negative/OmpCpositive sera suggest that many (52.0%) of these patients were more likely to have had UC or Crohn's colitis based on the presence of an atypical pANCA.Crohn's disease (CD) and ulcerative colitis (UC) are the two major forms of inflammatory bowel disease (IBD). Both CD and UC are chronic, affecting children and adults (men and women almost equally), and are most common in northern Europe and North America. The onset of CD and UC is usually between the ages of 15 and 30, with a second, smaller peak of incidence between the ages of 50 and 70 (4, 23). Approximately 20% of individuals with CD have a biological relative with some form of IBD, and several reports have noted an increase in the prevalence of CD and UC in various geographic regions (2,17,24,36).Although there are many theories about the etiology of CD and UC, none have been proven. Many of the symptoms of CD and UC are similar, and diagnosis is often difficult, time-consuming, and invasive. Since CD and UC are treated differently, correct diagnosis and differentiation are medically important.Two serological markers have been found to have clinical utility in diagnosing IBD and aiding in the differentiation of CD from UC: anti-Saccharomyces cerevisiae antibody (ASCA) (immunoglobulin A [IgA] and/or IgG), using enzyme immunoassay (EIA) techniques, and antineutrophil cytoplasmic antibody (ANCA) (IgG) that demonstrates atypical perinuclear staining (pANCA), using indirect fluorescent-antibody assay (IFA) techniques. ASCA is directed against mannose sequences in the cell wall of Saccharomyces cerevisiae (26,35) and...

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“…In adult populations with known CD, the frequency of ASCA (either IgG or IgA) has been reported to range from 28-59% (11)(12)(13)(14), while that of anti-ompC ranges from 37-56% (15,16). Published investigations in children with CD have revealed somewhat higher rates of detectable ASCA (44-76%) (5,17,18) but a lower rate for anti-ompC (24%) (5).…”

Section: Discussionmentioning

confidence: 96%

394 Age of Diagnosis Influences Serologic Responses in Children with Crohn Disease: A Possible Clue to Etiology?

Markowitz¹,

Kugathasan²,

Dubinsky³

et al. 2008

Gastroenterology

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Direct all correspondence to: James Markowitz, MD, Schneider Children's Hospital, 269-01 76 Ave, New Hyde Park, NY 11040, Phone: 718-470-3430, Fax: 718-962-2908 Crohn disease (CD) is often associated with antibodies to microbial antigens. Differences in immune response may offer clues to the pathogenesis of the disease.AIM-To examine the influence of age at diagnosis on serologic response in children with CD.METHODS-Data were drawn from 3 North American multicenter pediatric IBD research consortia. At or shortly after diagnosis, pANCA, ASCA IgA, ASCA IgG, anti-ompC and antiCBir1 were assayed. Results were compared as a function of age at CD diagnosis (0-7 years vs 8-15 years).RESULTS-705 children (79 <8 yr of age at diagnosis, 626 ≥8yr) were studied. Small bowel CD was less frequent in the younger group (48.7% vs 72.6%; p<0.0001) while colonic involvement was comparable (91.0% vs 86.5%). ASCA IgA and IgG were seen in <20% of those 0-7 yr compared to nearly 40% of those 8-15 yr (p<0.001), while anti-CBir1 was more frequent in the younger children (66% vs 54%, p<0.05). Anti-CBir1 detected a significant number of children in both age groups who otherwise were serologically negative. Both age at diagnosis and site of CD involvement were independently associated with expression of ASCA and anti-CBir1.CONCLUSIONS-Compared to children 8-15 yr of age at diagnosis, those 0-7 yr are more likely to express anti-CBir1 but only half as likely to express ASCA. These age-associated differences in antimicrobial seropositivity suggest that there may be different, and as yet unrecognized, genetic, immunologic and/or microbial factors leading to CD in the youngest children.

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Diagnostic role and clinical correlates of anti-Saccharomyces cerevisiae antibodies (ASCA) and anti-neutrophil cytoplasmic antibodies (p-ANCA) in Italian patients with inflammatory bowel diseases

Cited by 35 publications

References 37 publications

The Prevalence and Clinical Significance of Perinuclear Anti-neutrophil Cytoplasmic Antibody in Korean Patients with Ulcerative Colitis

The Prevalence and Clinical Significance of Perinuclear Anti-neutrophil Cytoplasmic Antibody in Korean Patients with Ulcerative Colitis

Analysis of Serum Antibodies in Patients Suspected of Having Inflammatory Bowel Disease

394 Age of Diagnosis Influences Serologic Responses in Children with Crohn Disease: A Possible Clue to Etiology?

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