The ability to identify children with Crohn's disease who are at highest risk for rapid progression from uncomplicated to complicated phenotypes would be invaluable in guiding initial therapy.
Dr Marla Dubinsky and colleagues from California, USA determined whether immune responses and/or CARD15 variants are associated with complicated disease phenotypes and predict disease progression.
The team collected sera from 796 pediatric Crohn's disease cases and tested for anti-Cbir1 (flagellin), anti–outer membrane protein C, anti–Saccharomyces cerevisiae, and perinuclear antineutrophil cytoplasmic antibody by using enzyme-linked immunosorbent assay.
The team performed Genotyping for 3 CARD15 variants, including single nucleotide polymorphisms 8, 12, and 13.
Associations between immune responses and clinical phenotype were evaluated.
The researchers found that 32% of patients developed at least 1 disease complication within a median of 32 months, and 18% underwent surgery.
The frequency of internal penetrating, stricturing, and surgery significantly increased with increasing antibody sum and quartile sum score.
|12% of seropositive groups underwent surgery|
|Clinical Gastroenterology & Hepatology|
The team observed that 9% of seropositive groups had internal penetrating/stricturing versus 3% in the seronegative group.
The research team noted that 12% of seropositive groups underwent surgery versus 2% in the seronegative group.
The highest antibody sum group and quartile sum score group demonstrated the most rapid disease progression.
Increased hazard ratio was observed for antibody sum group and quartile sum score group.
Dr Dubinsky’s team concluded, “The rate of complicated Crohn's Disease increases in children as the number and magnitude of immune reactivity increase.”
“Disease progression is significantly faster in children expressing immune reactivity.”