Background and aims: Several antibodies have been associated with Crohn's disease (CD) and are associated with distinct clinical phenotypes. Our aim 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 antibody pANCA were tested in serum samples of 1225 IBD patients, 200 healthy controls (HC) and 113 patients with non-IBD gastrointestinal inflammation (non-IBD GI). Antibody responses were correlated with type of disease and clinical characteristics.
Results: 76% of CD patients had at least one of the tested antibodies. For differentiation between CD and ulcerative colitis (UC), the combination of gASCA and pANCA was most accurate. For differentiation between IBD, HC and non-IBD GI, the combination of gASCA, pANCA and ALCA had the best accuracy. Increasing amount and level of antibody responses towards gASCA, ALCA, ACCA, AMCA and Omp was associated with more complicated disease behaviour (44.7% vs. 53.6% vs. 71.1% vs. 82.0%, p < .001), and higher frequency of CD-related abdominal surgery (38.5% vs. 48.8% vs. 60.7% vs. 75.4%, p < .001).
Conclusions: Using this new panel of serological markers, we showed that number and magnitude of immune responses to different microbial antigens are associated with severity of the disease. To conclude on the predictive role of serological markers, prospective longitudinal studies are necessary.
- inflammatory bowel disease
- serological markers