Clinical Research
Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Apr 28, 2007; 13(16): 2312-2318
Published online Apr 28, 2007. doi: 10.3748/wjg.v13.i16.2312
Update on Anti-Saccharomyces cerevisiae antibodies, anti-nuclear associated anti-neutrophil antibodies and antibodies to exocrine pancreas detected by indirect immunofluorescence as biomarkers in chronic inflammatory bowel diseases: Results of a multicenter study
S Desplat-Jégo, C Johanet, A Escande, J Goetz, N Fabien, N Olsson, E Ballot, J Sarles, JJ Baudon, JC Grimaud, M Veyrac, P Chamouard, RL Humbel
S Desplat-Jégo, CHU de la Conception, Marseille 13005, France
C Johanet, E Ballot, CHU Saint-Antoine, Paris, France
A Escande, CHU Saint-Eloi, Montpellier, France
J Goetz, CHU Hautepierre, Strasbourg, France
N Fabien, CHU Lyon-Sud, Pierre-Bénite, France
N Olsson, CHU Dijon, France
J Sarles, CHU Timone, Marseille, France
JJ Baudon, Hôpital Trousseau, Paris, France
JC Grimaud, CHU Nord Marseille 13005, France
M Veyrac, CHU Saint-Eloi, Montpellier, France
P Chamouard, CHU Hautepierre, Strasbourg, France
RL Humbel, Laboratoire Luxembourgeois d’Immunopathologie, Esch-sur-Alzette, Luxembourg. Services de gastro-entérologie et pédiatrie, France
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. S Desplat-Jégo, Laboratoire d'Immunologie, Hôpital de la Conception, 147, Bd Baille, Marseille 13005, France.
Telephone: +33-4-91383907 Fax: +33-4-91383633
Received: December 18, 2006
Revised: February 3, 2006
Accepted: March 6, 2007
Published online: April 28, 2007
Abstract

AIM: Anti-Saccharomyces cerevisiae antibodies (ASCA), anti-nuclear associated anti-neutrophil antibodies (NANA) and antibodies to exocrine pancreas (PAB), are serological tools for discriminating Crohn’s disease (CrD) and ulcerative colitis (UC). Like CrD, coeliac disease (CoD) is an inflammatory bowel disease (IBD) associated with (auto) antibodies. Performing a multicenter study we primarily aimed to determine the performance of ASCA, NANA and PAB tests for IBD diagnosis in children and adults, and secondarily to evaluate the prevalence of these markers in CoD.

METHODS: Sera of 109 patients with CrD, 78 with UC, 45 with CoD and 50 healthy blood donors were retrospectively included. ASCA, NANA and PAB were detected by indirect immunofluorescence (IIF).

RESULTS: ASCA+/NANA- profile displayed a positive predictive value of 94.2% for CrD. Detection of ASCA was correlated with a more severe clinical profile of CrD and treatment of the disease did not influence their serum levels. ASCA positivity was found in 37.9% of active CoD. PAB were found in 36.7% CrD and 13.3% CoD patients and were not correlated with clinical features of CrD, except with an early onset of the disease. Fifteen CrD patients were ASCA negative and PAB positive.

CONCLUSION: ASCA and PAB detected by IIF are specific markers for CrD although their presence does not rule out a possible active CoD. The combination of ASCA, NANA and PAB tests improves the sensitivity of immunological markers for CrD. Repeating ASCA, NANA, and PAB testing during the course of CrD has no clinical value.

Keywords: Inflammatory bowel disease; Coeliac disease; Anti-Saccharomyces cerevisiae antibodies; Anti-neutrophil cytoplasmic antibodies; Anti-pancreatic antibodies