Department of Internal Medicine I, University of Regensburg, Regensburg, Germany.
Inflamm Bowel Dis. 2010 Feb;16(2):263-74. doi: 10.1002/ibd.21046.
We tested a panel of novel serological anti-glycan antibodies including the previously unpublished anti-laminarin IgA (Anti-L) and anti-chitin IgA (Anti-C) carbohydrate antibodies for the presence in Crohn's disease (CD) patients, diagnosis and differentiation of CD, association with complicated disease behavior, and marker stability over time.
The presence of Anti-L, Anti-C, anti-chitobioside IgA (ACCA), anti-laminaribioside IgG (ALCA), anti-mannobioside IgG (AMCA), and anti-Saccaromyces cervisiae IgG (gASCA) carbohydrate antibodies were tested in serum samples from 824 participants (363 CD, 130 ulcerative colitis [UC], 74 other gastrointestinal diseases, and 257 noninflammatory bowel/gastrointestinal disease controls) of the German IBD-network by enzyme-linked immunosorbent assay (ELISA; Glycominds, Lod, Israel) and for perinuclear antineutrophil cytoplasmic antibody (pANCA) by immunofluorescence.
In all, 77.4% of the CD patients were positive for at least 1 of the anti-glycan antibodies. gASCA or the combination of gASCA/pANCA remained most accurate for the diagnosis of CD, but the combined use of the antibodies improved differentiation of CD from UC. Several single markers as well as an increasing antibody response were independently linked to a severe disease phenotype, as shown for the occurrence of complications, CD-related surgery, early disease onset, and ileal disease location. This was observed for both quantitative and qualitative antibody responses. The antibody status remained stable over time in most IBD patients.
A panel of anti-glycan antibodies including the novel Anti-L and Anti-C may aid in differentiation of CD from UC, is associated with complicated CD behavior and IBD-related surgery, and is stable over time in a large patient cohort.
我们测试了一组新型血清抗糖抗体，包括以前未发表的抗聚半乳糖醛酸（Anti-L）和抗几丁质 IgA（Anti-C）糖抗体，以检测克罗恩病（CD）患者中这些抗体的存在情况，用于 CD 的诊断和鉴别诊断，与复杂疾病行为的关联，以及随时间推移的标志物稳定性。
采用酶联免疫吸附试验（ELISA；Glycominds，Lod，以色列）检测 824 名参与者（363 名 CD、130 名溃疡性结肠炎[UC]、74 名其他胃肠道疾病和 257 名非炎症性肠病/胃肠道疾病对照组）血清样本中的 Anti-L、Anti-C、抗壳二糖 IgA（ACCA）、抗聚乳糖胺 IgG（ALCA）、抗甘露糖 IgG（AMCA）和抗酿酒酵母 IgG（gASCA）糖抗体，并通过免疫荧光法检测抗中性粒细胞胞质抗体（pANCA）。
所有 CD 患者中有 77.4%至少有一种抗糖抗体阳性。gASCA 或 gASCA/pANCA 的联合检测对 CD 的诊断仍然最准确，但这些抗体的联合使用提高了 CD 与 UC 的鉴别诊断能力。几种单标志物以及抗体应答的增加均与严重疾病表型独立相关，如并发症的发生、与 CD 相关的手术、疾病的早期发作和回肠疾病部位。这在定量和定性抗体反应中均有观察到。在大多数 IBD 患者中，抗体状态随时间保持稳定。
包括新型 Anti-L 和 Anti-C 的抗糖抗体谱可能有助于 CD 与 UC 的鉴别诊断，与 CD 复杂行为和 IBD 相关手术相关，并且在大型患者队列中随时间推移保持稳定。
