Anti-<i>Saccharomyces cerevisiae</i> Antibodies in Patients with Inflammatory Bowel Disease and Their First-Degree Relatives: Potential Clinical Value

Abstract

Anti-Saccharomyces cerevisiae antibodies (ASCA) have been described as specific markers in Crohn’s disease and their healthy first-degree relatives. 171 patients with Crohn’s disease, their 105 first-degree relatives, 145 patients with ulcerative colitis and 101 first-degree relatives of patients with ulcerative colitis, 50 patients with infectious enterocolitis and 100 healthy controls were tested for ASCA employing the ELISA technique. When compared with the healthy controls (p < 0.0001) and patients with infectious enterocolitis (p < 0.0001) the prevalence of ASCA was significantly increased in patients with Crohn’s disease and their first-degree relatives (p < 0.01). Further significant differences concerning the frequency of ASCA within the different groups of our study population were not observed. In particular, ASCA were not found in increased prevalence in infectious enterocolitis. These observations are compatible with a role of ASCA as a marker of genetic predisposition to Crohn’s disease.

Serum Antibodies in First-Degree Relatives of Patients with IBD: A Marker of Disease Susceptibility? A Follow-Up Pilot-Study after 7 Years

“…Previous studies showed occurrence of various antibodies such as p-ANCA [6, 13], ASCA [1], antibodies against endothelial cells [16] or antinuclear antibodies [17] not only in patients with Crohn’s disease or ulcerative colitis, but also in their still healthy first-degree relatives, who display a significantly increased risk to develop inflammatory bowel disease. Therefore, an implication of these antibodies in inflammatory bowel disease comprises their use as potential markers of disease susceptibility.…”

“…Therefore, an implication of these antibodies in inflammatory bowel disease comprises their use as potential markers of disease susceptibility. In line with this concept is the observa tion that inflammatory bowel disease-specific antibodies are – with few exceptions, such as endothelial cell antibodies [16] – not found in increased prevalence in infectious enterocolitis [1] or in spouses of patients [17]. However, due to the lack of long-term follow-up data about the course of antibody-positive first-degree relatives, the potential role of these serum markers in reflecting disease susceptibility still remains speculative so far.…”

“…ASCA IgA and ASCA IgG have been detected by ELISA (Medizym, for details, see ref. [1]) whereas for the remainder of antibodies indirect immunofluorescence had been performed as described in detail elsewhere [11, 12]. Seven years after collection of serum samples, first degree-relatives were interviewed applying a standardized questionnaire, which assessed the following symptoms: Diarrhea of more than three days duration, anal discharge of mucus or blood, weight loss, abdominal pain, ocular inflammation, cutaneous nodules or ulcerations and arthralgias.…”

“…Although not exclusively present in inflammatory bowel disease, the most prominent examples to date are antibodies against Saccharomyces cerevisiae (ASCA) and perinuclear-antineutrophil cytoplasmic autoantibodies (p-ANCA). ASCA are regarded as serologic markers for Crohn’s disease and can be found in about two thirds of these patients [1,2,3], whereas p-ANCA occur in 45 to 80% of patients with ulcerative colitis [4,5,6,7]. As opposed to ASCA, which were recently described also in association with HLA-B27 associated spondylarthropathies [8, 9], antibodies against exocrine pancreas (PAB) are highly disease-specific [10], but are present only in about one third of patients with Crohn’s disease [11].…”

“…ASCA [1], p-ANCA [6, 13] and GAB [12] are found in increased prevalence also in first degree relatives of patients with inflammatory bowel disease, in particular if the index patient displays the respective antibody. PAB were also associated with the occurrence of inflammatory bowel disease in first-degree relatives of patients with Crohn’s disease [14].…”