Arnott, I.D.R.; Landers, C.J.; Targan, S.R.; Satsangi, J.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA68
Academic Journal
Introduction: The diagnostic value and pathogenic importance of serological markers in patients with inflammatory bowel disease remain under evaluation. Antibodies directed against Saccharomyces cerevisiae (ASCA) and the perinuclear component of neutrophils (pANCA) have been the most widely studied and may be of diagnostic importance. OmpC and 12, antibodies directed against luminal bacterial components (E coli and pseudomonas respectively), have recently been described in Crohn's disease (CD). The data reported in the Los Angeles population suggest a selective loss of tolerance to microbial antigens in CD. Phenotypic associations of these antibodies are unknown. We aimed to assess the frequency of ASCA, pANCA, OmpC, and 12 in an independent CD cohort and establish phenotypic associations. Methods: 141 well-characterised CD patients (76 females, median age 39years (17-88)) and 78 healthy controls (HC) were studied. 36 had ileal disease, 58 had colonic disease and 57 had both ileal and colonic disease. 42 had associated perianal disease. 73 had undergone previous surgery. ELISA assayed ASCA, ANCA, OmpC, and 12. The pattern of ANCA positivity was assessed by immunoflourescence. Results: All antibodies were more prevalent in CD than HC (ASCA 39% v4%, ANCA 14% v 1%, 12 52% v 10%, OmpC 37% v 1%, all p<0.001). A positive serum ASCA was associated with ileal disease (76% v 42%, p<0.001) and previous surgical resection (73% v 37%, p<0.001) where as pANCA was a marker for colonic disease (63% v 30%, p<0.05). OmpC and 12 were associated with increasing age, increasing disease duration and the need for intestinal resection (p<0.001). OmpC is also associated with ileal disease (p<0.01). Conclusion: We have confirmed the previous association of ASCA and ileal disease and ANCA and colonic disease. OmpC is also associated with ileal disease and OmpC and 12 are associated with increasing disease duration.


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