COMMENTARY
ASCA
ASCA: genetic marker, predictor of disease, or marker of a response to an environmental antigen?
Correspondence to:
Correspondence to:
Professor F Seibold
Department of Gastroenterology, Inselspital, Freiburgstrasse, 3010 Bern, Switzerland; frank.seibold@insel.ch
Anti-Saccharomyces cerevisiae antibodies (ASCA) may be a marker of an immune response to an environmental antigen that occurs in the context of early stage Crohn’s disease
Keywords: anti-Saccharomyces cerevisiae antibodies; antineutrophil cytoplasmic antibodies; Crohn’s disease; ulcerative colitis
| The first 150 words of the full text of this article appear below. |
The presence of antibodies against the yeast Saccharomyces cerevisiae (ASCA) and against neutrophils (pANCA) has been used as diagnostic serological markers for inflammatory bowel disease (IBD) for many years. The combination of a positive ASCA test with a negative pANCA test has a positive predictive value of 96% and a specificity of 97% for Crohn’s disease (CD).1 However, both antibodies have been found in other diseases, such as autoimmune liver disease, primary sclerosing cholangitis (pANCA), and in gluten sensitive enteropathy (ASCA). Therefore, their role as diagnostic serological markers for IBD seems to be limited.
Antibody determination is of interest in patients with indeterminate colitis. However, almost 50% of these patients do not develop ASCA or pANCA antibodies whereas in antibody positive patients, ASCA+/pANCA– predicts CD in 80% of patients with indeterminate colitis and ASCA–/pANCA+ predicts ulcerative colitis (UC) in 64%.2
Generation of both antibodies is poorly understood. Several studies
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- Anti-Saccharomyces cerevisiae and antineutrophil cytoplasmic antibodies as predictors of inflammatory bowel disease
- E Israeli, I Grotto, B Gilburd, R D Balicer, E Goldin, A Wiik, and Y Shoenfeld
Gut 2005 54: 1232-1236.[Abstract] [Full Text] [PDF]
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