Anti-Saccharomyces cerevisiae and antineutrophil cytoplasmic antibodies as predictors of inflammatory bowel disease
Anti-Saccharomyces cerevisiae and antineutrophil cytoplasmic antibodies as predictors of inflammatory bowel disease
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DOI：
10.1136/gut.2004.060228
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发表时间：
2005-09-01
期刊：
影响因子：
24.5
通讯作者：
Shoenfeld, Y
中科院分区：
文献类型：
--
作者：
Israeli, E;Grotto, I;Shoenfeld, Y
背景和目的：据报道，克罗恩病 (CD) 和溃疡性结肠炎 (UC) 患者的血清中存在多种抗体。最常见的是 CD 中的抗酿酒酵母甘露聚糖抗体 (ASCA) 和 UC 中的核周抗中性粒细胞胞质抗体 (pANCA)。这些抗体的家族聚集已被描述，表明它们可能是遗传标记。我们的目的是在出现明显的临床表现之前调查这些抗体的存在。方法：自 1980 年以来，以色列国防军 (IDF) 医疗队血清库储存了从 5% 的入伍新兵以及从义务兵役退伍的同一人群中系统获取的血清样本。我们评估了 32 名 CD 受试者和 8 名 UC 受试者在临床诊断前获得的血清样本，以及来自匹配对照的样本。结果：临床诊断前 CD 患者中有 10/32 (31.3%) 存在 ASCA，而对照者为 0/95 (0%) (p< 0.001)。在诊断 UC 之前获得血清样本的 8 名患者中，无一例 ASCA 呈阳性。诊断 CD 后，54.5% 的患者 ASCA 呈阳性。 ASCA 检测和诊断之间的平均间隔为 38 个月。 90% 的患者在第一个可用的血清样本中检测到了抗体；因此，测量从出现 ASCA 到诊断的平均时间可能会更长。在诊断 UC 之前，2/8 (25%) 患者的可用血清中存在 pANCA。他们的 24 个匹配对照均未呈阳性（p = 0.014）。结论：ASCA 和 pANCA 可以在临床诊断疾病之前数年预测炎症性肠病的发展。
Background and aims: Several antibodies have been reported in the sera of patients with Crohn's disease ( CD) and ulcerative colitis (UC). The most commonly described are anti-Saccharomyces cerevisiae mannan antibodies (ASCA) in CD and perinuclear antineutrophil cytoplasm antibodies (pANCA) in UC. Familial clustering of these antibodies has been described, suggesting they might be genetic markers. Our aim was to investigate the presence of these antibodies before the emergence of overt clinical manifestations.Methods: Since 1980, the Israeli Defense Force (IDF) Medical Corps Serum Repository has stored serum samples obtained systematically from 5% of all recruits on enlistment, and from the same population on discharge from compulsory military service. We evaluated serum samples obtained from 32 subjects with CD and eight with UC before they were clinically diagnosed, along with samples from matched controls.Results: ASCA were present in 10/32 (31.3%) CD patients before clinical diagnosis compared with 0/95 (0%) controls ( p< 0.001). None of the eight patients with serum samples available before diagnosis of UC were ASCA positive. ASCA was positive in 54.5% of patients after diagnosis of CD. The mean interval between ASCA detection and diagnosis was 38 months. In 90% of patients, antibodies were detected in the first available serum sample; therefore, measurements of the average time from the presence of ASCA to diagnosis may be even longer. pANCA were present in 2/8 (25%) patients with available sera before the diagnosis of UC. None of their 24 matched controls were positive ( p = 0.014).Conclusions: ASCA and pANCA may predict development of inflammatory bowel disease years before the disease is clinically diagnosed.