University Department of Chemistry, Medical School University Hospital Sestre Milosrdnice, Zagreb, Croatia.
Biochem Med (Zagreb). 2013;23(1):28-42. doi: 10.11613/bm.2013.006.
Inflammatory bowel disease (IBD) is a heterogeneous group of chronic inflammatory disorders of the gastrointestinal tract with two main distinguishable entities, Crohn's disease (CD) and ulcerative colitis (UC). IBD-unclassified (IBD-U) is a diagnosis that covers the "grey" zone of diagnostic uncertainty between UC and CD. Current diagnosis of IBD relies on the clinical, endoscopic, radiological, histological and biochemical features, but this approach has shortcomings especially in cases of overlapping symptoms of CD and UC. The need for a diagnostic tool that would improve the conventional methods in IBD diagnosis directed the search towards potential immunological markers, since an aberrant immune response against microbial or endogenous antigens in a genetically susceptible host seems to be implicated in IBD pathogenesis. The spectrum of antibodies to different microbial antigens and autoantibodies associated with IBD is rapidly expanding. Most of these antibodies are associated with CD like anti-glycan antibodies: anti-Saccharomices cerevisiae (ASCA) and the recently described anti-laminaribioside (ALCA), anti-chitobioside (ACCA), anti-mannobioside (AMCA), anti-laminarin (anti-L) and anti-chitin (anti-C) antibodies; in addition to other antibodies that target microbial antigens: anti-outer membrane porin C (anti-OmpC), anti-Cbir1 flagellin and anti-12 antibody. Also, autoantibodies targeting the exocrine pancreas (PAB) were shown to be highly specific for CD. In contrast, UC has been associated with anti-neutrophil cytoplasmic autoantibodies (pANCA) and antibodies against goblet cells (GAB). Current evidence suggests that serologic panels of multiple antibodies are useful in differential diagnosis of CD versus UC and can be a valuable aid in stratifying patients according to disease phenotype and risk of complications.
炎症性肠病（IBD）是一种异质性的胃肠道慢性炎症性疾病，主要有两种可区分的实体，即克罗恩病（CD）和溃疡性结肠炎（UC）。未分类的炎症性肠病（IBD-U）是一种诊断，涵盖了 UC 和 CD 之间诊断不确定性的“灰色”区域。目前的 IBD 诊断依赖于临床、内镜、放射学、组织学和生物化学特征，但这种方法在 CD 和 UC 症状重叠的情况下存在缺陷。需要一种能够改善 IBD 诊断的常规方法的诊断工具，这促使人们寻找潜在的免疫标志物，因为在遗传易感宿主中，针对微生物或内源性抗原的异常免疫反应似乎与 IBD 的发病机制有关。与 IBD 相关的不同微生物抗原和自身抗体的抗体谱正在迅速扩大。这些抗体大多数与 CD 相关，如抗聚糖抗体：抗酿酒酵母（ASCA）和最近描述的抗层粘连蛋白（ALCA）、抗壳二糖（ACCA）、抗甘露糖（AMCA）、抗层粘连蛋白（抗-L）和抗几丁质（抗-C）抗体；此外，还有其他针对微生物抗原的抗体：抗外膜孔蛋白 C（anti-OmpC）、抗 Cbir1 鞭毛和抗 12 抗体。此外，针对外分泌胰腺的自身抗体（PAB）被证明对 CD 具有高度特异性。相比之下，UC 与抗中性粒细胞细胞质自身抗体（pANCA）和针对杯状细胞的抗体（GAB）相关。目前的证据表明，针对多种抗体的血清学面板在 CD 与 UC 的鉴别诊断中很有用，并且可以根据疾病表型和并发症风险对患者进行分层，是一种有价值的辅助手段。
