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Prognostic aid for use in the clinical management of patients who have been diagnosed with Crohn's disease.
The absence of antibody reactivity in this panel, although associated with increased incidence of a more benign course, does not preclude the future development of more complicated disease or need for surgery.1
The presence and increasing titer of these antibodies has been shown to correlate with a more complicated disease course (strictures or fistulas) or the need for surgery. The antibodies included in the panel are ASCA (anti-Saccharomyces cerevisiae antibodies), ALCA (antilaminaribioside carbohydrate antibodies), ACCA (antichitobioside carbohydrate antibodies), and AMCA (antimannobioside carbohydrate antibodies).1-3 Numerous studies of CD have demonstrated an association between ileal disease and the presence of ASCA,1-7 ACCA,1 ALCA,1,3 and AMCA.3 Among these antibodies, the association with localization to the small intestine increased with the number of positive antibodies and with the concentration of individual antibodies.1-3,6,8 A more aggressive or complicated disease course in CD (as indicated by stricturing or perforation of the intestine or need of surgery), has also been associated with the presence of ASCA,1-3,5,7 ALCA,1-3 ACCA,1,2 and AMCA.1,2 Among these antibodies, the association with complicated disease behavior or surgery increased with the number and concentration of antibodies.1,2,6,8
1. Ferrante M, Henckaerts L, Joossens M, et al. New serological markers in inflammatory bowel disease are associated with complicated disease behavior. Gut. 2007 Oct; 56(10):1394-1403. PubMed 17456509
2. Papp M, Altorjay I, Dotan N, et al. New serological markers for inflammatory bowel disease are associated with earlier age at onset, complicated disease behavior, risk for surgery, and NOD2/CARD15 genotype in a Hungarian IBD cohort. Am J Gastroenterol. 2008 Mar; 103(3):665-681. PubMed 18047543
3. Dotan I, Fishman S, Dgani Y, et al. Antibodies against laminaribioside and chitobioside are novel serologic markers in Crohn's disease. Gastroenterology. 2006 Aug; 131(2):366-378. PubMed 16890590
4. Vasiliauskas EA, Plevy SE, Landers CJ, et al. Perinuclear antineutrophil cytoplasmic antibodies in patients with Crohn's disease define a clinical subgroup. Gastroenterology. 1996 Jun; 110(6):1810-1819. PubMed 8964407
5. Vasiliauskas EA, Kam LY, Karp LC, Gaiennie J, Yang H, Targan SR. Marker antibody expression stratifies Crohn's disease into immunologically homogeneous subgroups with distinct clinical characteristics. Gut. 2000 Oct; 47(4):487-496. PubMed 10986208
6. Arnott ID, Landers CJ, Nimmo EJ, et al. Sero-reactivity to microbial components in Crohn's disease is associated with disease severity and progression, but not NOD2/CARD15 genotype. Am J Gastroenterol. 2004 Dec; 99(12):2376-2384. PubMed 15571586
7. Walker LJ, Aldhous MC, Drummond HE, et al. Anti-Saccharomyces cerevisiae antibodies (ASCA) in Crohn's disease are associated with disease severity but not NOD2/CARD15 mutations. Clin Exp Immunol. 2004 Mar; 135(3):490-496. PubMed 15008984
8. Mow WS, Vasiliauskas EA, Lin YC, et al. Association of antibody responses to microbial antigens and complications of small bowel Crohn's disease. Gastroenterology. 2004 Feb; 126(2):414-424. PubMed 14762777
