Van Kemseke C, Belaïche J, Steeman C, Louis E
Department of Gastroenterology, Centre Hospitalier Universitaire de Liège, Domaine Universitaire du Sart Tilman, B35, 4000 Liège, Belgium.
Acta Gastroenterol Belg. 2003 Jan-Mar;66(1):1-6.
Crohn's disease (CD) is a polygenic multifactorial heterogeneous disease. Anti-Saccharomyces Cerevisiae antibodies (ASCA) correlate highly with CD and are present in 50-80% of patients. The reason for ASCA positivity or negativity in CD is unknown. The aim of our work was to analyse clinical, epidemiological and genetic characteristics in ASCA+ or ASCA- CD patients.
113 patients with CD were tested for ASCA (IgA and IgG) by using a commercial kit (Medipan Diagnostica). Age, gender, systemic manifestations, familial form of disease, age at diagnosis, location and behaviour of the disease, smoking habit as well as genotyping for -308 TNF gene polymorphisms were determined.
38.9% CD patients were negative for both IgA and IgG ASCA while 61.1% were ASCA positive (respectively IgA and IgG: 31.9%; IgA only: 9.7%; IgG only: 19.5%). The only significant difference between ASCA+ and ASCA- patients was for smoking habit: there were 29% smokers in ASCA+ versus 50% in ASCA- CD patients (P = 0.03). This low proportion of smokers was more prominent in ASCA IgA+ patients than in isolated ASCA IgG+ patients (25.6% versus 45.5%) and was minimal in patients with high titers of ASCA IgA (0/8). Logistic regression showed smoking habit still borderline for significance (P = 0.057).
Our results suggest a negative association between smoking and ASCA positivity in CD. This association was more prominent for ASCA IgA+. It indicates that smoking habit should be taken into account when analysing ASCA status in CD patients and may suggest an influence of smoking on immunization against intestinal material.
克罗恩病（CD）是一种多基因多因素的异质性疾病。抗酿酒酵母抗体（ASCA）与CD高度相关，50 - 80%的患者体内存在该抗体。CD患者ASCA阳性或阴性的原因尚不清楚。我们研究的目的是分析ASCA阳性或阴性的CD患者的临床、流行病学和遗传学特征。
使用商用试剂盒（Medipan Diagnostica）对113例CD患者进行ASCA（IgA和IgG）检测。确定患者的年龄、性别、全身表现、疾病家族形式、诊断年龄、疾病部位和行为、吸烟习惯以及 - 308 TNF基因多态性的基因分型。
38.9%的CD患者IgA和IgG ASCA均为阴性，而61.1%的患者ASCA阳性（分别为IgA和IgG：31.9%；仅IgA：9.7%；仅IgG：19.5%）。ASCA阳性和阴性患者之间唯一的显著差异在于吸烟习惯：ASCA阳性患者中有29%吸烟，而ASCA阴性的CD患者中有50%吸烟（P = 0.03）。ASCA IgA阳性患者中的吸烟者比例低于单纯ASCA IgG阳性患者（25.6%对45.5%），在ASCA IgA高滴度患者中最低（0/8）。逻辑回归显示吸烟习惯的显著性仍接近临界值（P = 0.057）。
我们的结果表明CD患者吸烟与ASCA阳性之间存在负相关。这种关联在ASCA IgA阳性患者中更为显著。这表明在分析CD患者的ASCA状态时应考虑吸烟习惯，并且可能提示吸烟对肠道物质免疫的影响。
