INFLAMMATORY BOWEL DISEASE

New serological markers in inflammatory bowel disease are associated with complicated disease behaviour

Marc Ferrante¹, Liesbet Henckaerts¹, Marie Joossens¹, Marie Pierik¹, Sofie Joossens¹, Nir Dotan², Gary L Norman³, Rom T Altstock², Kristel Van Steen⁴, Paul Rutgeerts¹, Gert Van Assche¹, Séverine Vermeire¹

¹ Department of Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium
² Glycominds Ltd, Lod, Israel
³ INOVA Diagnostics Inc, San Diego, CA, USA
⁴ Department of Applied Mathematics and Computer Science, University Gent, Belgium

Correspondence to:
Professor Séverine Vermeire
Department of Gastroenterology, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium; severine.vermeire{at}uz.kuleuven.be

Background and aims: Several antibodies have been associated with Crohn’s disease and are associated with distinct clinical phenotypes. The aim of this study was to determine whether a panel of new antibodies against bacterial peptides and glycans could help in differentiating inflammatory bowel disease (IBD), and whether they were associated with particular clinical manifestations.

Methods: Antibodies against a mannan epitope of Saccharomyces cerevisiae (gASCA), laminaribioside (ALCA), chitobioside (ACCA), mannobioside (AMCA), outer membrane porins (Omp) and the atypical perinuclear antineutrophilic cytoplasmic antibody (pANCA) were tested in serum samples of 1225 IBD patients, 200 healthy controls and 113 patients with non-IBD gastrointestinal inflammation. Antibody responses were correlated with the type of disease and clinical characteristics.

Results: 76% of Crohn’s disease patients had at least one of the tested antibodies. For differentiation between Crohn’s disease and ulcerative colitis, the combination of gASCA and pANCA was most accurate. For differentiation between IBD, healthy controls and non-IBD gastrointestinal inflammation, the combination of gASCA, pANCA and ALCA had the best accuracy. Increasing amounts and levels of antibody responses against gASCA, ALCA, ACCA, AMCA and Omp were associated with more complicated disease behaviour (44.7% versus 53.6% versus 71.1% versus 82.0%, p < 0.001), and a higher frequency of Crohn’s disease-related abdominal surgery (38.5% versus 48.8% versus 60.7% versus 75.4%, p < 0.001).

Conclusions: Using this new panel of serological markers, the number and magnitude of immune responses to different microbial antigens were shown to be associated with the severity of the disease. With regard to the predictive role of serological markers, further prospective longitudinal studies are necessary.

Abbreviations: ACCA, Anti-chitobioside carbohydrate antibody; ALCA, anti-laminaribioside carbohydrate antibody; AMCA, anti-mannobioside carbohydrate antibody; AUC, area under the curve; gASCA, anti-Saccharomyces cerevisiae antibody; IBD, inflammatory bowel disease; Omp, outer membrane porin; pANCA, perinuclear anti-neutrophilic cytoplasmic antibody; ROC, receiver operating characteristic

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