Abstract
BackgroundUlcerative colitis (UC) is a chronic, non-specific inflammatory bowel disease (IBD) with unknown etiology. The lack of specific clinical manifestations, standard diagnostic criteria, objective and accurate indicators to the severity of the disease and the efficacy of the treatment, often results in difficulties in diagnosis and timely treatment of UC. Therefore, there is a need to develop a clinically suitable serum biomarker assay with high specificity and sensitivity.Objective and methodsTo explore the significance of anti-neutrophil cytoplasmic antibodies (ANCA) and anti-saccharomyces cerevisiae antibodies (ASCA) in the diagnosis, differential diagnosis and treatment assessment in patients with ulcerative colitis (UC). Serum levels of ANCA-IgG, ASCA-IgA and ASCA-IgG were measured by an enzyme-linked immunosorbent assay (ELISA) in 105 UC patients, 52 non-UC patients and 100 healthy controls.Results(1) Both the ANCA-IgG level and its positive rate in UC patients were significantly higher than those in non-UC controls and healthy controls (p < 0.01). However, the levels of ASCA-IgA, ASCA-IgG and the positive rates in UC patients had no statistical differences when compared with those in non-UC controls or healthy controls (p > 0.05). (2) The sensitivity of ANCA+ and ANCA+/ASCA− in detecting UC patients was 61.90% and 55.24%, respectively, whereas the specificity was 91.45% and 94.08%, respectively. The sensitivity of ASCA+ and ASCA+/ANCA− in non-UC disease controls was 5.33% and 3.85%, respectively, and specificity was 83.9% and 88.78%, respectively. (3) When UC patients were grouped into mild, moderate or severe subtypes, the ANCA-IgG levels were correlated with the severity of UC, and the differences of the ANCA-IgG levels were statistically different among the three subtypes (p < 0.05). There was no correlation between the levels of ANCA-IgG and the disease locations of UC.Conclusions(1) Serum levels of ANCA may be useful in the diagnosis of UC. (2) Dynamic quantitation of ANCA-IgG levels may be helpful in determining the severity of UC and therefore, may guide treatment of UC.
Highlights
Ulcerative colitis (UC) is a chronic, non-specific inflammatory bowel disease (IBD) with unknown etiology
By detecting serum levels of ANCAIgG, anti-Saccharomyces cerevisiae antibody (ASCA)-IgA and ASCA-IgG, we have investigated the clinical significance of these antibodies in UC diagnosis, differential diagnosis, and possible correlations of antibody levels to the disease state and to the treatment efficacy
Serum levels of Antineutrophil cytoplasmic antibodies (ANCA), ASCA and the positive rates among the three comparison groups Our data suggested that: (1) The ANCA-IgG level and positive rate in UC group were significantly higher than those of disease control group and healthy control group,the differences were statistically significant (p < 0.01); There were no significant differences in ANCAIgG level and positive rate between disease control group and healthy control group (p > 0.05); (2) There were no significant differences in ASCA-IgA, ASCA-IgG levels and positive rate among UC group, disease control group and healthy control group
Summary
Ulcerative colitis (UC) is a chronic, non-specific inflammatory bowel disease (IBD) with unknown etiology. Quantitative measurements of UC-related auto-antibodies would be helpful for the clinical diagnosis and treatment assessment of UC. An antibody named as atypical nuclear ANCA (atypical p-ANCA) has been related to UC [3, 4]. Another antibody highly associated with IBD is anti-Saccharomyces cerevisiae antibody (ASCA) which is directed against the yeast genus. ASCA mainly targets at peptidemimetic polysaccharide on the cell wall of the yeast. The mechanisms of these antibodies involved in IBD may be related to the increased intestinal permeability of the disease and the exposure to immune response cells of yeast antibodies [5]. By detecting serum levels of ANCAIgG, ASCA-IgA and ASCA-IgG, we have investigated the clinical significance of these antibodies in UC diagnosis, differential diagnosis, and possible correlations of antibody levels to the disease state and to the treatment efficacy
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