Perinuclear antineutrophil cytoplasmic antibodies, and anti-Saccharomyces cerevisiae antibodies are proposed to be specific markers for ulcerative colitis and Crohn's disease.
However, their prevalence and relationship to disease phenotype and outcome in unselected cohorts of patients with inflammatory bowel disease (IBD), is largely unclear.
Dr Inger Camilla Solberg and colleagues from Norway studied the prevalence of these serologic markers in a population-based IBD cohort 10 years after diagnosis.
|27% of Crohn’s disease patients were ASCA-positive|
|Inflammatory Bowel Diseases|
In addition, the team examined whether their presence could be related to distinct subgroups, and outcome of disease.
Of 685 living IBD patients, 620 met for a 10-year follow-up, of whom 526 participated in this study.
The research team noted that 27% of Crohn’s disease patients were ASCA-positive, and 31% of ulcerative colitis patients were pANCA-positive.
Positive ASCA was more frequent in Crohn’s disease patients with stricturing or penetrating complications than in those with inflammatory behavior at diagnosis.
The researchers found that the presence of ASCA was associated with an at least twice higher risk of evolving more severe disease behavior during follow-up.
In ulcerative colitis, pANCA expression was related to female gender, and the use of azathioprine, and in Crohn’s disease, to colon-limited disease and age 40 years at diagnosis.
Dr Solberg’s team comments, “The prevalence of ASCA in Crohn’s disease, and pANCA in ulcerative colitis appears markedly lower than in referral-based populations.”
“Even with the low prevalence, our study gives further support to the role of ASCA and pANCA as markers for distinct phenotype and outcome of disease.”