Pang Yanhua, Ruan Huijie, Wu Dongfang, Lang Yanfei, Sun Ke, Xu Cuiping
1Department of Gastroenterology, Beijing Chaoyang Hospital, Capital Medical University, Chaoyang District, Beijing, 100020 China.
2Department of Gastroenterology, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi 300001 China.
Allergy Asthma Clin Immunol. 2020 May 20;16:37. doi: 10.1186/s13223-020-00433-1. eCollection 2020.
Ulcerative colitis (UC) is a chronic, non-specific inflammatory bowel disease (IBD) with unknown etiology. The lack of specific clinical manifestations, standard diagnostic criteria, objective and accurate indicators to the severity of the disease and the efficacy of the treatment, often results in difficulties in diagnosis and timely treatment of UC. Therefore, there is a need to develop a clinically suitable serum biomarker assay with high specificity and sensitivity.
To explore the significance of anti-neutrophil cytoplasmic antibodies (ANCA) and anti-saccharomyces cerevisiae antibodies (ASCA) in the diagnosis, differential diagnosis and treatment assessment in patients with ulcerative colitis (UC). Serum levels of ANCA-IgG, ASCA-IgA and ASCA-IgG were measured by an enzyme-linked immunosorbent assay (ELISA) in 105 UC patients, 52 non-UC patients and 100 healthy controls.
(1) Both the ANCA-IgG level and its positive rate in UC patients were significantly higher than those in non-UC controls and healthy controls ( < 0.01). However, the levels of ASCA-IgA, ASCA-IgG and the positive rates in UC patients had no statistical differences when compared with those in non-UC controls or healthy controls ( > 0.05). (2) The sensitivity of ANCA and ANCA/ASCA in detecting UC patients was 61.90% and 55.24%, respectively, whereas the specificity was 91.45% and 94.08%, respectively. The sensitivity of ASCA and ASCA/ANCA in non-UC disease controls was 5.33% and 3.85%, respectively, and specificity was 83.9% and 88.78%, respectively. (3) When UC patients were grouped into mild, moderate or severe subtypes, the ANCA-IgG levels were correlated with the severity of UC, and the differences of the ANCA-IgG levels were statistically different among the three subtypes ( < 0.05). There was no correlation between the levels of ANCA-IgG and the disease locations of UC.
(1) Serum levels of ANCA may be useful in the diagnosis of UC. (2) Dynamic quantitation of ANCA-IgG levels may be helpful in determining the severity of UC and therefore, may guide treatment of UC.
溃疡性结肠炎（UC）是一种病因不明的慢性非特异性炎症性肠病（IBD）。由于缺乏特异性临床表现、标准诊断标准以及评估疾病严重程度和治疗效果的客观准确指标，UC的诊断和及时治疗常常存在困难。因此，需要开发一种临床适用的、具有高特异性和敏感性的血清生物标志物检测方法。
探讨抗中性粒细胞胞浆抗体（ANCA）和抗酿酒酵母抗体（ASCA）在溃疡性结肠炎（UC）患者诊断、鉴别诊断及治疗评估中的意义。采用酶联免疫吸附试验（ELISA）检测105例UC患者、52例非UC患者和100例健康对照者血清中ANCA-IgG、ASCA-IgA和ASCA-IgG水平。
（1）UC患者的ANCA-IgG水平及其阳性率均显著高于非UC对照者和健康对照者（<0.01）。然而，UC患者的ASCA-IgA、ASCA-IgG水平及其阳性率与非UC对照者或健康对照者相比，差异无统计学意义（>0.05）。（2）ANCA和ANCA/ASCA检测UC患者的敏感性分别为61.90%和55.24%，特异性分别为91.45%和94.08%。ASCA和ASCA/ANCA检测非UC疾病对照者的敏感性分别为5.33%和3.85%，特异性分别为83.9%和88.78%。（3）将UC患者分为轻度、中度或重度亚型时，ANCA-IgG水平与UC严重程度相关，三种亚型之间ANCA-IgG水平差异有统计学意义（<0.05）。ANCA-IgG水平与UC病变部位无关。
（1）血清ANCA水平可能有助于UC的诊断。（2）动态定量检测ANCA-IgG水平可能有助于判断UC的严重程度，从而指导UC的治疗。
