Department of Internal Medicine I, University of Regensburg, Regensburg, Germany.
Inflamm Bowel Dis. 2010 Aug;16(8):1367-75. doi: 10.1002/ibd.21179.
A high proportion of patients with Crohn's disease (CD) over time develop complications like fistulae and strictures, requiring surgery. We tested a panel of antiglycan antibodies for predicting the occurrence of complications and CD-related surgery in an adult patient cohort.
Serum samples of 149 CD patients of the German inflammatory bowel disease (IBD) network were tested for the presence of anti-laminarin IgA (Anti-L), anti-chitin IgA (Anti-C), anti-chitobioside IgA (ACCA), anti-laminaribioside IgG (ALCA), anti-mannobioside IgG (AMCA), and anti-Saccaromyces cerevisiae IgG (gASCA) carbohydrate antibodies by enzyme-linked immunosorbent assay (ELISA) (IBDX(R) panel, Glycominds, Lod, Israel) in a blinded fashion. Clinical data were available on occurrence of complicated disease or CD-related surgery as well as disease activity, onset, and location.
The median follow-up of the patients without any previous complication or surgery at time of sample procurement was 53.7 months. Overall, 26.3% developed a complication and 17.1% underwent CD-related surgery, respectively. Positivity for gASCA, AMCA, ACCA, and Anti-L alone or an increasing frequency of positive serum antibodies independently predicted a faster progression toward a more severe disease course. Once a complication or surgery had occurred only positivity for Anti-L or more than 3 markers out of the whole panel indicated progression to an additional surgery or complication. The antibody status of most patients remained stable over time.
This is the first study showing the clinical value of serum antiglycan antibodies for prediction of a more complicated disease course in adult patients with CD.
随着时间的推移，相当一部分克罗恩病（CD）患者会出现瘘管和狭窄等并发症，需要手术治疗。我们测试了一组针对聚糖的抗体，以预测成年患者队列中并发症的发生和与 CD 相关的手术。
德国炎症性肠病（IBD）网络的 149 名 CD 患者的血清样本通过酶联免疫吸附试验（ELISA）（IBDX（R）面板，Glycominds，Lod，以色列）以盲法检测抗海藻糖 IgA（Anti-L）、抗几丁质 IgA（Anti-C）、抗壳二糖 IgA（ACCA）、抗海藻糖-β-内酰胺 IgG（ALCA）、抗甘露糖-β-内酰胺 IgG（AMCA）和抗酿酒酵母 IgG（gASCA）糖抗体。临床数据可用于发生复杂疾病或与 CD 相关的手术以及疾病活动、发病和位置。
在样本采集时没有任何先前并发症或手术的患者的中位随访时间为 53.7 个月。总体而言，26.3%的患者发生并发症，17.1%的患者接受与 CD 相关的手术。gASCA、AMCA、ACCA 和 Anti-L 单独阳性或血清抗体阳性频率增加可独立预测疾病向更严重的方向进展。一旦发生并发症或手术，仅 Anti-L 阳性或整个面板中超过 3 个标志物阳性表明会进展为额外的手术或并发症。大多数患者的抗体状态随时间保持稳定。
这是第一项表明血清抗聚糖抗体对预测成年 CD 患者更复杂疾病过程具有临床价值的研究。
