Anti-Saccharomyces cerevisiae antibody does not differentiate between Crohn's disease and intestinal tuberculosis
Anti-Saccharomyces cerevisiae antibody does not differentiate between Crohn's disease and intestinal tuberculosis
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DOI：
10.1007/s10620-006-9527-0
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发表时间：
2007-01-01
影响因子：
3.1
通讯作者：
Pandey, R. M.
中科院分区：
文献类型：
--
作者：
Makharia, Govind K.;Sachdev, Vikas;Pandey, R. M.
肠结核（IT）和克罗恩病（CD）的临床、形态学和组织学特征如此相似，以至于很难区分它们。抗酿酒酵母抗体（ASCA）IgG和ASCA伊加对CD的敏感性为60%~ 80%，特异性接近90%。目前尚无ASCA在IT患者中的研究报告，也从未用于区分CD和IT。本研究包括溃疡性结肠炎（UC; n= 25）、CD（n= 59）和IT（n= 30）患者以及21名健康对照。CD的位置和行为根据Modified Montreal分类进行分类。从他们身上抽取5毫升血液，血清储存在-70摄氏度。使用市售ELISA试剂盒（AESKU Diagnostics，德国）估计ASCA抗体（IgG和伊加）。用间接免疫荧光法检测抗嗜酸性粒细胞胞浆抗体。ASCA伊加阳性率分别为4.7%、28%、33.9%和43.3%，ASCAIgG阳性率分别为4.7%、24%、50.8%和46.6%。ASCA IgG或ASCA伊加在健康对照、UC、CD和IT中分别为9.5%、40%、61%和66.6%。ANCA在健康对照组、UC、CD和IT中的阳性率分别为0%、32%、10.1%和6.6%。与健康对照组相比，CD（P < 0.0001）和IT（P < 0.0001）患者中ASCA IgG呈阳性。ASCA伊加在UC（P < 0.04）、CD（P < 0.013）和IT（P < 0.006）患者中的阳性率显著高于健康对照组。在疾病之间的比较中，ASCA IgG在CD（P < 0.001）和IT（P < 0.001）患者中的阳性率显著高于UC患者。CD和IT患者中ASCA伊加（33.9% vs. 43.3%）、ASCA IgG（50.86% vs. 46.6%）或ANCA（10.7%，7.4%）无显著差异。ASCA与CD的病程、部位、行为及IT均无相关性，ASCA IgG和ASCA伊加对IT和CD的鉴别无帮助。
The clinical, morphological, and histological features of intestinal tuberculosis (IT) and Crohn's disease (CD) mimic so much, that it becomes difficult to differentiate between them. The sensitivity of anti-Saccharomyces cerevisiae antibody (ASCA) IgG and ASCA IgA in CD is 60%-80%, whereas the specificity is almost 90%. There are no reports of study of ASCA in patients with IT, nor has it ever been used to differentiate CD from IT. Patients with ulcerative colitis (UC; n= 25), CD ( n= 59), and IT ( n= 30) and 21 healthy controls were included in this study. The location and behavior of CD were classified according to the Modified Montreal classification. Five milliliters of blood was taken from them and serum was stored at -70 degrees C. ASCA antibodies ( both IgG and IgA) were estimated using commercially available ELISA kits (AESKU Diagnostics, Germany). Anti-neutrophilic cytoplasmic antibody was measured by indirect immunoflorescence test. ASCA IgA was positive in 4.7%, 28%, 33.9%, and 43.3% and ASCAIgG was positive in 4.7%, 24%, 50.8%, and 46.6% of healthy controls and patients with UC, CD, and IT, respectively. Either ASCA IgG or ASCA IgA was positive in 9.5%, 40%, 61% and 66.6% of healthy controls, UC, CD, and IT, respectively. ANCA was positive in 0%, 32%, 10.1%, and 6.6% of healthy controls, UC, CD, and IT, respectively. ASCA IgG was positive in a significantly higher number of patients with CD ( P < 0.0001) and IT ( P < 0.0001) in comparison to healthy controls. ASCA IgA was positive in a significantly higher number of patients with UC ( P < 0.04), CD ( P < 0.013), and IT ( P < 0.006) in comparison to healthy controls. In comparisons between diseases, ASCA IgG was positive in significantly more patients with CD ( P < 0.001) and IT ( P < 0.001) in comparison to UC. There was no significant difference in ASCA IgA (33.9% vs. 43.3%), ASCA IgG (50.86% vs. 46.6%), or ANCA (10.7%, 7.4%) in patients with CD and IT, respectively. There was no correlation between ASCA and duration, location and behavior of CD, and IT. We conclude that ASCA IgG and ASCA IgA do not help to differentiate between IT and CD.