Anti-Saccharomyces cerevisiae antibodies and its relationship with radiological damage in ankylosing spondylitis

Eman El-Dessoky El-Shahawy,Inas M El-Fiki,Alaa A Al Moaty Omran,Hanan Samir,Ghada S Nageeb,Dalia S Fahmy

doi:10.4103/1110-161x.132456

Eman El-Dessoky El-Shahawy, Inas M El-Fiki + Show 4 more

Open Access

https://doi.org/10.4103/1110-161x.132456

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Abstract

AimThe presence of anti-Saccharomyces cerevisiae antibodies (ASCA) is controversial in ankylosing spondylitis (AS). In this study, we aimed to investigate the prevalence of ASCA in AS and its relationship with disease activity and radiological damage in patients attending Sharkia governorate hospitals.Patients and methodsThirty AS patients and 30 apparently healthy volunteers were included in the present study. All patients were questioned for Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis metrology Index and Bath Ankylosing Functional Index (BASFI). Total Bath Ankylosing Spondylitis Radiology Index (BASRI-T) and ASCA levels were measured.ResultsASCA IgA level was significantly higher in AS patients than in healthy controls (P < 0.001). The ASCA-positive group, although not significant, tended to have higher BASFI scores. ASCA IgA-positive patients had higher BASRI-T levels (P = 0.037). In AS patients, significant positive correlation was found between ASCA IgA level and BASRI-T and BASFI (r = 0.19 and 0.31, respectively, P < 0.05). Bath Ankylosing Spondylitis Disease Activity Index scores, BASFI and ASCA IgA positivity were significantly associated with increased BASRI-T (P= 0.01, 0.03 and 0.04, respectively). The most significant risk factor for increased BASRI-T is ASCA IgA positivity (P < 0.001).ConclusionASCA IgA was detected more frequently in AS patients than in healthy controls. ASCA IgA could be considered a marker of severe radiological damage. Further studies are recommended to investigate ASCA level versus radiological damage and intestinal involvement in AS patients.

Highlights

Spondyloarthropathies (SpAs) are a group of diseases characterized by chronic inflammation of the axial and peripheral joints with common clinical, biological and genetic characteristics [1]
Because of the inflammatory bowel disease (IBD)-like mucosal changes that occur in a substantial percentage of ankylosing spondylitis (AS) patients, Palm et al [5] hypothesized that serologic activity normally used to detect loss of tolerance to enteric antigens related to mucosal dysregulation in IBD will be detectable in levels above normal controls in AS patients
Analytical results of univariate analysis were presented as the odds ratio (OR) and 95% confidence interval (CI)

Summary

Introduction

Spondyloarthropathies (SpAs) are a group of diseases characterized by chronic inflammation of the axial and peripheral joints with common clinical, biological and genetic characteristics [1]. They are characterized by dactylitis and enthesopathy as well as inflammation of the extra-articular sites such as eyes, skin and gut [2]. Anti-Saccharomyces cerevisiae antibodies (ASCA) have been suggested as a serological marker for the diagnosis of undetermined IBD, their pathological role is not yet clear [6]. ASCA are directed against the cell wall of S. cerevisiae, commonly known as Baker’s or Brewer’s yeast [7]

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