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Serological markers predict IBD years before the diagnosis

May's issue of Gut identifies serological markers that predict IBD years before the diagnosis.

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Anti-neutrophil cytoplasmic antibodies and anti-Saccharomyces cerevisiae mannan antibodies (ASCAs) have been detected in the serum of patients with ulcerative colitis and Crohn's disease, and their unaffected family members.

Dr Bas Oldenburg and colleagues from the Netherlands established the value of serological markers as predictors of ulcerative colitis and Crohn's disease.

Individuals who developed Crohn's disease or ulcerative colitis were identified from the European Prospective Investigation into Cancer and Nutrition (EPIC) study.

At recruitment, none of the participants had a diagnosis of Crohn's disease or ulcerative colitis.

For each incident case, 2 controls were randomly selected matched for center, date of birth, sex, date of recruitment and time of follow-up.

167 were diagnosed with ulcerative colitis after a mean follow-up of 4.5 years
Gut

The team analyzed serum of cases and controls obtained at recruitment for ASCA IgG, ASCA IgA, perinuclear anti-neutrophil cytoplasmic antibody (pANCA), antibodies against Escherichia coli outer membrane porin C (OmpC) and flagellin CBir1.

The research team used conditional logistic regression to determine risk of Crohn's disease and ulcerative colitis.
 
Receiver operating characteristic curves were constructed to test accuracy.

A total of 77 individuals were diagnosed with Crohn's disease, and 167 with ulcerative colitis after a mean follow-up of 4.5, and 4.4 years following blood collection, respectively.

The team found that the combinations of pANCA, ASCA, anti-CBir1 and anti-OmpC were most accurate in predicting incident Crohn's disease and ulcerative colitis.

The research team found that the predictive value of the combination of markers increased when time to diagnosis of Crohn's disease or ulcerative colitis decreased.

Dr Oldenburg's team commented, "A panel of serological markers is able to predict development of Crohn's disease and ulcerative colitis in individuals from a low-risk population."

Gut 2013; 62: 683-688
04 April 2013

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