Crohn’s disease patients may have antibody responses to Crohn’s disease-related bacterial sequence, as well as Escherichia coli outer membrane porin C, Saccharomyces cerevisiae (oligomannan), and neutrophil nuclear antigens.
In this study, physicians from California determined whether this antibody response was associated with distinct phenotypic manifestations.
|Anti-E. coli outer membrane porin C is associated with internal perforations.|
The team tested sera from 303 patients for antibodies to the Crohn’s disease-related bacterial sequence (I2), anti-E. coli outer membrane porin C, and anti-S. cerevisiae. They also tested for perinuclear antineutrophil cytoplasmic antibodies and for 3 Crohn’s disease-associated variants of the NOD2 gene.
The physicians found that patients expressing I2 were more likely to have fibrostenosing Crohn’s disease (64% versus 41%). They were also more likely to require small bowel surgery.
In addition, patients with anti-E. coli outer membrane porin C were more likely to have internal perforating disease (50% versus 31%). These patients were also more likely to require small bowel surgery.
The team also found that anti-Crohn’s disease-related bacterial sequence was independently associated with fibrostenosis and small bowel surgery.
Anti-E. coli outer membrane porin C was independently associated with internal perforations.
The team established that patients who were positive for I2, anti-E. coli outer membrane porin C, and anti-S. cerevisiae were the most likely to have undergone small bowel surgery.
Overall, they determined that 90% of patients who required surgery had high levels of I2, E. coli outer membrane porin C, and oligomannan antibodies.
Dr William Mow's team concluded, "I2 and anti-E. coli outer membrane porin C are associated with Crohn’s disease phenotypes>"
"Patients with the highest level of serum reactivity toward an increasing number of microbiota have the greatest frequency of strictures, internal perforations, and small bowel surgery".