Perinuclear antineutrophil cytoplasmic antibodies in patients with Crohn's disease define a clinical subgroup
Perinuclear antineutrophil cytoplasmic antibodies in patients with Crohn's disease define a clinical subgroup
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DOI：
10.1053/gast.1996.v110.pm8964407
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发表时间：
1996-06-01
期刊：
影响因子：
29.4
通讯作者：
Targan, SR
中科院分区：
文献类型：
--
作者：
Vasiliauskas, EA;Plevy, SE;Targan, SR
背景和目的：在克罗恩病 (CD) 患者亚组中一致检测到抗中性粒细胞胞浆抗体 (ANCA)。本研究旨在确定 CD 患者的血清 ANCA 表达是否代表可识别的临床亚组的特征。方法：研究人群由 69 名连续患者组成，根据临床特征、影像学、内窥镜和组织病理学标准的结合，确定了 CD 的诊断。使用固定中性粒细胞酶联免疫吸附测定 (ELISA) 分析患者血清中 ANCA 的存在。通过间接免疫荧光染色证实了 ELISA 的核周 ANCA (pANCA) 阳性和细胞质 ANCA (cANCA) 阳性结果。将 ANCA 阳性 CD 患者的临床特征与不表达 ANCA 的 CD 患者（ANCA 阴性）的临床特征进行比较。结果：pANCA 阳性 CD 患者经内镜和/或组织病理学记录有左侧结肠炎和左侧结肠炎症症状，临床表现为直肠出血和粘液排出、尿急和局部用药治疗。 100% 表达 pANCA 的 CD 患者具有“UC 样”特征。结论：在 CD 患者中，血清 pANCA 表达具有 UC 样临床表型的特征。通过血清 pANCA 对 CD 进行分层提供了 CD 内异质性的证据，并表明在表达该标志物的 CD 和 UC 患者的可定义亚组中存在常见的肠粘膜炎症过程。
Background & Aims: Antineutrophil cytoplasmic antibodies (ANCA) have been consistently detected in a subgroup of patients with Crohn's disease (CD). This study was designed to determine whether serum ANCA expression in patients with CD characterizes an identifiable clinical subgroup. Methods: The study population consisted of 69 consecutive patients with an established diagnosis of CD as determined by a combination of characteristic clinical, radiographic, endoscopic, and histopathologic criteria. Sera from the patients were analyzed for the presence of ANCAs using the fixed neutrophil enzyme-linked immunosorbent assay (ELISA) assay. Perinuclear ANCA (pANCA)-positive and cytoplasmic ANCA (cANCA)-positive results by ELISA were confirmed by indirect immunofluorescence staining. Clinical profiles of the ANCA-positive patients with CD were compared with those of patients with CD not expressing ANCA (ANCA-negative). Results: pANCA-positive patients with CD have endoscopically and/or histopathologically documented left-sided colitis and symptoms of left-sided colonic inflammation, clinically reflected by rectal bleeding and mucus discharge, urgency, and treatment with topical agents. One hundred percent of patients with CD expressing pANCA had "UC-like" features. Conclusions: In patients with CD, serum pANCA expression characterizes a UC-like clinical phenotype. Stratification of CD by serum pANCA provides evidence of heterogeneity within CD and suggests a common intestinal mucosal inflammatory process among a definable subgroup of patients with CD and UC expressing this marker.