Editorial
Copyright ©The Author(s) 2007. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 14, 2007; 13(14): 2028-2036
Published online Apr 14, 2007. doi: 10.3748/wjg.v13.i14.2028
Utility of serological markers in inflammatory bowel diseases: Gadget or magic?
Maria Papp, Gary L Norman, Istvan Altorjay, Peter Laszlo Lakatos
Maria Papp, Istvan Altorjay, Department of Gastroenterology, University of Debrecen, Debrecen, Hungary
Gary L Norman, INOVA Diagnostics, Inc. San Diego, United States
Peter Laszlo Lakatos, 1st Department of Medicine, Semmelweis University, Budapest, Hungary
Author contributions: All authors contributed equally to the work.
Supported by Mecenatúra (11/2005) grant
Correspondence to: Peter Laszlo Lakatos, MD, PhD, 1st Department of Medicine, Semmelweis University, Koranyi str. 2/A H-1083, Hungary. kislakpet@bel1.sote.hu
Telephone: +36-1-2100278-1500 Fax: +36-1-3130250
Received: February 6, 2007
Revised: March 2, 2007
Accepted: March 12, 2007
Published online: April 14, 2007
Abstract

The panel of serologic markers for inflammatory bowel diseases (IBD) is rapidly expanding. Although anti-Saccharomyces cerevisiae antibodies (ASCA) and atypical perinuclear antineutrophil cytoplasmic antibodies (P-ANCA) remain the most widely investigated, an increasing amount of experimental data is available on newly discovered antibodies directed against various microbial antigens. The role of the assessment of various antibodies in the current IBD diagnostic algorithm is often questionable due to their limited sensitivity. In contrast, the association of serologic markers with disease behavior and phenotype is becoming increasingly well-established. An increasing number of observations confirms that patients with Crohn’s disease expressing multiple serologic markers at high titers are more likely to have complicated small bowel disease (e.g. stricture and/or perforation) and are at higher risk for surgery than those without, or with low titers of antibodies. Creating homogenous disease sub-groups based on serologic response may help develop more standardized therapeutic approaches and may help in a better understanding of the pathomechanism of IBD. Further prospective clinical studies are needed to establish the clinical role of serologic tests in IBD.

Keywords: Serologic markers; Inflammatory bowel disease; Ulcerative colitis; Crohn’s disease; Indeterminate colitis; Antineutrophil cytoplasmic antibodies; Anti-Saccharomyces cerevisiae mannan antibodies; Outer membrane porin