Department of Internal Medicine I, University of Regensburg, Regensburg, Germany.
PLoS One. 2011 May 6;6(5):e18172. doi: 10.1371/journal.pone.0018172.
Anti-glycan antibodies are a promising tool for differential diagnosis and disease stratification of patients with Crohn's disease (CD). We longitudinally assessed level and status changes of anti-glycan antibodies over time in individual CD patients as well as determinants of this phenomenon.
859 serum samples derived from a cohort of 253 inflammatory bowel disease (IBD) patients (207 CD, 46 ulcerative colitis (UC)) were tested for the presence of anti-laminarin (Anti-L), anti-chitin (Anti-C), anti-chitobioside (ACCA), anti-laminaribioside (ALCA), anti-mannobioside (AMCA) and anti-Saccharomyces cerevisiae (gASCA) antibodies by ELISA. All patients had at least two and up to eleven serum samples taken during the disease course.
Median follow-up time for CD was 17.4 months (Interquartile range (IQR) 8.0, 31.6 months) and for UC 10.9 months (IQR 4.9, 21.0 months). In a subgroup of CD subjects marked changes in the overall immune response (quartile sum score) and levels of individual markers were observed over time. The marker status (positive versus negative) remained widely stable. Neither clinical phenotype nor NOD2 genotype was associated with the observed fluctuations. In a longitudinal analysis neither changes in disease activity nor CD behavior led to alterations in the levels of the glycan markers. The ability of the panel to discriminate CD from UC or its association with CD phenotypes remained stable during follow-up. In the serum of UC patients neither significant level nor status changes were observed.
While the levels of anti-glycan antibodies fluctuate in a subgroup of CD patients the antibody status is widely stable over time.
抗聚糖抗体是克罗恩病（CD）患者鉴别诊断和疾病分层的有前途的工具。我们纵向评估了个体 CD 患者随时间推移抗聚糖抗体的水平和状态变化，以及这种现象的决定因素。
来自 253 例炎症性肠病（IBD）患者（207 例 CD，46 例溃疡性结肠炎（UC））队列的 859 份血清样本通过 ELISA 检测抗-聚半乳糖醛酸（Anti-L）、抗几丁质（Anti-C）、抗壳二糖（ACCA）、抗-聚半乳糖胺（ALCA）、抗甘露糖（AMCA）和抗酿酒酵母（gASCA）抗体的存在。所有患者在疾病过程中至少有两次，最多有十一次血清样本。
CD 的中位随访时间为 17.4 个月（四分位距（IQR）8.0，31.6 个月），UC 为 10.9 个月（IQR 4.9，21.0 个月）。在 CD 受试者的亚组中，观察到总体免疫反应（四分位和评分）和个别标志物水平随时间的显著变化。标志物状态（阳性与阴性）保持广泛稳定。临床表型或 NOD2 基因型均与观察到的波动无关。在纵向分析中，疾病活动度的变化或 CD 行为均未导致聚糖标志物水平的改变。该标志物组在随访期间仍能区分 CD 与 UC 或与其 CD 表型相关。在 UC 患者的血清中，既未观察到显著的水平变化，也未观察到状态变化。
虽然在亚组 CD 患者中抗聚糖抗体的水平波动，但抗体状态在随时间推移广泛稳定。
