Anticarbohydrate antibodies as markers of inflammatory bowel disease in a Central European cohort.

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BACKGROUND:
The study discusses the role of antichitobioside carbohydrate antibody (ACCA), antilaminaribioside carbohydrate antibodies (ALCA), and antimannobioside carbohydrate antibodies (AMCA) in Central European patients with inflammatory bowel diseaseBoth Crohn's disease and ulcerative colitisUsually diagnosed at a younger age (IBDInflammatory bowel diseaseCommon inflammatory disorder with complex etiology that involves both genetic and environmental triggers, including but not limited to defects in bacterial clearance, defective mucosal barrier and persistent dysregulation of the immune response to commensal intestinal bacteria).

PATIENTS AND METHODS:
Twohundred and seventy-two serum samples were used - 116 Crohn's disease (CD), 84 ulcerative colitisUlcerative colitisChronic inflammatory bowel disease of the colorectum, with mucosal infiltration by activated leukocytes, which are the result of complex interactions between lymphocytes, antigen, and dendritic cells (DCs), and 72 healthy control samples. All samples were evaluated using enzyme-linked immunosorbent assayEnzyme-linked immunosorbent assayTime-consuming method for the measurement of faecal calprotectin for the following four anticarbohydrate assays: ACCA, ALCA, AMCA, and anti-Saccharomyces cerevisiae antibodiesAnti-saccharomyces cerevisiae antibodiesReportedly useful in distinguishing ulcerative colitis (UC) from Crohn's disease (CD), there are few and conflicting reports assessing their utility in predicting postoperative complications after ileal pouch-anal anastomosis (IPAA) (gASCA).

RESULTS:
gASCA antibodies showed the highest sensitivity (67%) for a CD diagnosis, followed by AMCA (31%), ACCA (27%), and ALCA (25%). Positivity of at least one of the four assays increased the overall sensitivity of antibody testing in CD up to 85.5%. Mean serum gASCA levels were significantly higher in CD patients who were younger at diagnosis and had a longer disease duration before blood sampling (P<0.001). In nonstricturing, nonpenetrating CD, serum gASCA levels were lower than in patients with stricturing and/or penetrating behavior (P<0.05). The strongest association of gASCA was found with ileocolonic CD and with upper gastrointestinal diseaseGastrointestinal diseaseMajor cause of morbidity and mortality worldwide each year (P<0.001). No association between anticarbohydrate (AMCA, ACCA, and ALCA) antibodies and CD location, behavior, age at onset, and disease duration was found; however, that sample size of some of our subgroups was probably too small to make firm conclusions on associations with all CD phenotypes. None of the assessed anticarbohydrate assays was predictive of colonic CD in patients in whom the distinction between CD and ulcerative colitisUlcerative colitisChronic inflammatory bowel disease of the colorectum, with mucosal infiltration by activated leukocytes, which are the result of complex interactions between lymphocytes, antigen, and dendritic cells (DCs) is not obvious using routine diagnostic methods. There was no relationship between the presence or concentration of anticarbohydrate antibodies and the inflammationInflammationCaused by dietary gluten, a peptide present in wheat, barley and rye measured by C-reactive proteinC-reactive proteinAcute-phase protein that is produced in large amounts by hepatocytes, upon stimulation by the cytokines interleukin-6, tumor-necrosis-factor-alpha and interleukin-1beta, during an acute-phase response levels.

CONCLUSION:
The use of a panel of anticarbohydrate antibodies may provide additional help in distinguishing IBDInflammatory bowel diseaseCommon inflammatory disorder with complex etiology that involves both genetic and environmental triggers, including but not limited to defects in bacterial clearance, defective mucosal barrier and persistent dysregulation of the immune response to commensal intestinal bacteria from non-IBDInflammatory bowel diseaseCommon inflammatory disorder with complex etiology that involves both genetic and environmental triggers, including but not limited to defects in bacterial clearance, defective mucosal barrier and persistent dysregulation of the immune response to commensal intestinal bacteria disease patterns. The addition of AMCA, ALCA, and ACCA assays as IBDInflammatory bowel diseaseCommon inflammatory disorder with complex etiology that involves both genetic and environmental triggers, including but not limited to defects in bacterial clearance, defective mucosal barrier and persistent dysregulation of the immune response to commensal intestinal bacteria serology markers improves the overall sensitivity of immunological examinations in IBDInflammatory bowel diseaseCommon inflammatory disorder with complex etiology that involves both genetic and environmental triggers, including but not limited to defects in bacterial clearance, defective mucosal barrier and persistent dysregulation of the immune response to commensal intestinal bacteria; however, anticarbohydrate assays are not helpful for predicting CD behavior.

Published In:

European journal of gastroenterology & hepatology • Feb 2010

Authors & Affiliation:

Malickova, Karin; Lakatos, Peter L; Bortlik, Martin; Komarek, Viktor; Janatkova, Ivana; Lukas, Milan
Institute of Clinical Biochemistry and Laboratory Diagnostics, General University Hospital and First Faculty of Medicine of Charles University, Budapest, Hungary.

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Terminology Definitions on this Page

What's This?Terminology definitions come from medical journal articles which appear in this category.

Anti-saccharomyces cerevisiae antibodies (ASCA)
Reportedly useful in distinguishing ulcerative colitis (UC) from Crohn's disease (CD), there are few and conflicting reports assessing their utility in predicting postoperative complications after ileal pouch-anal anastomosis (IPAA)

Both Crohn's disease and ulcerative colitis (inflammatory bowel disease)
Usually diagnosed at a younger age

C-reactive protein (CRP)
Acute-phase protein that is produced in large amounts by hepatocytes, upon stimulation by the cytokines interleukin-6, tumor-necrosis-factor-alpha and interleukin-1beta, during an acute-phase response

Enzyme-linked immunosorbent assay (ELISA)
Time-consuming method for the measurement of faecal calprotectin

Gastrointestinal disease
Major cause of morbidity and mortality worldwide each year

Inflammation
Caused by dietary gluten, a peptide present in wheat, barley and rye

Inflammatory bowel disease (IBD)
Common inflammatory disorder with complex etiology that involves both genetic and environmental triggers, including but not limited to defects in bacterial clearance, defective mucosal barrier and persistent dysregulation of the immune response to commensal intestinal bacteria

Ulcerative colitis (UC)
Chronic inflammatory bowel disease of the colorectum, with mucosal infiltration by activated leukocytes, which are the result of complex interactions between lymphocytes, antigen, and dendritic cells (DCs)

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