Annese V, Piepoli A, Perri F, Lombardi G, Latiano A, Napolitano G, Corritore G, Vandewalle P, Poulain D, Colombel J F, Andriulli A
Divisione di Gastroenterologia, Ospedale CSS-IRCCS, San Giovanni Rotondo, Italy.
Aliment Pharmacol Ther. 2004 Nov 15;20(10):1143-52. doi: 10.1111/j.1365-2036.2004.02258.x.
Anti-Saccharomyces cerevisiae mannan antibodies have been proposed as a new serological marker associated with Crohn's disease. However, their clinical value is still unclear; furthermore, a standardization of anti-S. cerevisiae mannan measurements is lacking.
In this study, we aimed to assess the correlation between anti-S. cerevisiae mannan detection and specific clinical features in Crohn's disease and ulcerative colitis. Moreover, we tested the concordance of four different anti-S. cerevisiae mannan assays.
Serum samples from 196 patients with Crohn's disease, 197 patients with ulcerative colitis and 100 unrelated healthy controls were tested for anti-S. cerevisiae mannan with a standard enzyme-linked immunosorbent assay method (Lille) by one of the authors (VP). Subsequently, 60 randomly selected serum samples (27 Crohn's disease, 28 ulcerative colitis and five healthy controls) were tested for anti-S. cerevisiae mannan with three different commercial kits.
With the Lille assay, anti-S. cerevisiae mannan were detected in 100 of 196 patients with Crohn's disease (51%; P < 0.0001 vs. controls), 32 of 197 patients with ulcerative colitis (16%; P < 0.02 vs. controls), and six of 100 controls (6%). No correlation between presence of anti-S. cerevisiae mannan and specific clinical features was found in both ulcerative colitis and Crohn's disease patients. The percentages of anti-S. cerevisiae mannan detected with four different assays ranged from 28 (Bouty) up to 43% (Inova), but these differences did not reach statistical significance. The concordance rate of anti-S. cerevisiae mannan detection in the four assays was very low (11 concordant results of 60 samples, 18.3%) (k = 0.15). No improvement of the concordance rate was obtained by modifying the suggested cut-off values (k = 0.20).
In this study, we confirm that anti-S. cerevisiae mannan are significantly more frequent in Crohn's disease patients compared with ulcerative colitis patients (P < 0.0001) and controls. However, no correlation with clinical features was found in both ulcerative colitis and Crohn's disease. The low prevalence of anti-S. cerevisiae mannan, at least in our population, and the low concordance rate between different assays, makes the clinical role of this marker questionable.
抗酿酒酵母甘露聚糖抗体已被提议作为与克罗恩病相关的一种新的血清学标志物。然而，其临床价值仍不明确；此外，抗酿酒酵母甘露聚糖检测缺乏标准化。
在本研究中，我们旨在评估抗酿酒酵母甘露聚糖检测与克罗恩病和溃疡性结肠炎特定临床特征之间的相关性。此外，我们检测了四种不同抗酿酒酵母甘露聚糖检测方法的一致性。
由一位作者（VP）采用标准酶联免疫吸附测定法（里尔法）对196例克罗恩病患者、197例溃疡性结肠炎患者和100名无关健康对照者的血清样本进行抗酿酒酵母甘露聚糖检测。随后，对60份随机选取的血清样本（27例克罗恩病患者、28例溃疡性结肠炎患者和5名健康对照者）用三种不同的商业试剂盒进行抗酿酒酵母甘露聚糖检测。
采用里尔法检测时，196例克罗恩病患者中有100例（51%）检测到抗酿酒酵母甘露聚糖（与对照相比，P<0.0001），197例溃疡性结肠炎患者中有32例（16%）（与对照相比，P<0.02），100名对照者中有6例（6%）。在溃疡性结肠炎和克罗恩病患者中，均未发现抗酿酒酵母甘露聚糖的存在与特定临床特征之间存在相关性。用四种不同检测方法检测到的抗酿酒酵母甘露聚糖百分比范围为28%（布蒂法）至43%（英诺法），但这些差异未达到统计学显著性。四种检测方法中抗酿酒酵母甘露聚糖检测的一致率非常低（60个样本中有11个一致结果，18.3%）（κ=0.15）。通过修改建议的临界值，一致率未得到改善（κ=0.20）。
在本研究中，我们证实与溃疡性结肠炎患者（P<0.0001）和对照相比，抗酿酒酵母甘露聚糖在克罗恩病患者中更为常见。然而，在溃疡性结肠炎和克罗恩病中均未发现与临床特征相关。抗酿酒酵母甘露聚糖的低患病率，至少在我们的研究人群中如此，以及不同检测方法之间的低一致率，使得该标志物的临床作用存疑。
