Dr Christine Olbjørn and colleagues from Norway described the prevalence of serological markers in newly diagnosed treatment-naïve pediatric inflammatory bowel disease (IBD), their utility in differentiating Crohn’s disease (CD), ulcerative colitis (UC) and symptomatic non-IBD patients, and whether serological markers are associated with early TNF blocker treatment.
The researchers included 96 children and adolescents <18 years, 58 with IBD and 38 symptomatic non-IBD controls.
At diagnosis and after 1–2 years, serological antibodies, flagellin expressed by Clostridial phylum, outer membrane porin of Escherichia coli, Pseudomonas fluorescens-associated sequence, CRP, ESR and fecal calprotectin were analyzed.
The team made the choice of treatment at the discretion of the treating pediatrician.
Of the IBD patients, the research team found that 36% and 47% were positive for ASCA and pANCA compared to 8% and 27% of the controls.
|72% of UC patients were pANCA positive|
|Scandanavian Journal of Gastroenterology|
The researchers noted that 72% of UC patients were pANCA positive, and 35% of CD patients.
The team observed that none of the UC patients was ASCA positive versus 54% of CD patients.
Compared to conventionally treated patients, the 49% TNF blocker treated CD patients had higher presence of ASCA, lower presence of pANCA, and higher levels of fecal calprotectin, CRP and ESR at diagnosis.
The team determined that ASCA and pANCA status, but not CRP, ESR or calprotectin, were independently associated with early TNF blocker treatment.
Dr Olbjørn's team commented, "ASCA and pANCA status were associated with having IBD, and with early TNF blocker treatment in CD."