Auto-Antibodies and Their Association with Clinical Findings in Women Diagnosed with Microscopic Colitis

Roth, Bodil; Gustafsson, Rita; Ohlsson, Bodil

doi:10.1371/journal.pone.0066088

Cited by 30 publications

(27 citation statements)

References 38 publications

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“…Information regarding certain autoimmune conditions was also lacking. In the present study, the 95% CI for the proportion of IgG positive samples ranged between 16% and 30%, which is comparable to the frequency of IgG positivity found in diseases of autoimmune origin, such as type 1 diabetes mellitus [27], systemic lupus erythematosus [28] and microscopic colitis [29], but lower than in Crohn’s disease [30]. No significant association was however detected between ASCA and disorders such as hypothyroidism or diabetes (the majority of the diabetic patients had type II diabetes).…”

Section: Discussionsupporting

confidence: 79%

Anti-Saccharomyces cerevisiae antibodies (ASCA) are associated with body fat mass and systemic inflammation, but not with dietary yeast consumption: a cross-sectional study

2017

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BackgroundBaker’s/brewer’s yeast, Saccharomyces cerevisiae, has been used as an alternative to antibiotic growth promoters to improve growth performance in animals. In humans, Saccharomyces cerevisiae is among the most commonly detected fungi in fecal samples and likely originates from food. Recently, an association between anti-Saccharomyces cerevisiae antibodies (ASCA) and obesity in humans was suggested, but the cause of the elevated ASCA levels is not clear. Our aim was to study ASCA in morbidly obese subjects and explore potential associations with anthropometrics, diet, co-morbidities and biomarkers of inflammation and gut permeability.MethodsSubjects with morbid obesity referred to a specialized hospital unit were included. Diet and clinical data were recorded with self-administered questionnaires. Main dietary sources of baker’s/brewer’s yeast (e.g. bread and beer) were used as a proxy for the intake of yeast. Laboratory analyses included ASCA, serum zonulin (reflecting gut permeability), C-reactive protein and a routine haematological and biochemical screening.ResultsOne-hundred-and-forty subjects; 109 (78%) female, 98 with dietary records, mean age 43 years and BMI 42 kg/m2 were included. The number of ASCA positive subjects was 31 (22%) for IgG, 4 (2.9%) for IgA and 3 (2.1%) for IgM. Age, body fat mass and C-reactive protein were significantly higher in IgG-positive compared to IgG-negative subjects (P < 0.05). A borderline significant association was found between elevated zonulin and ASCA IgG-positivity (P = 0.06). No association was found between yeast-containing food and ASCA IgG-positivity, or between yeast-containing food and fat mass.ConclusionsThe findings indicate that ASCA IgG-positivity may be linked to the generalized inflammation commonly seen with increased adiposity, but not to dietary yeast intake. Other potential causes for the raised ASCA IgG concentrations, such as genetic predisposition, deviations in the gut microbiota and cross-reactivity of ASCA with other antigens, were not explored.

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Section: Discussionsupporting

confidence: 79%

Anti-Saccharomyces cerevisiae antibodies (ASCA) are associated with body fat mass and systemic inflammation, but not with dietary yeast consumption: a cross-sectional study

2017

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“…Several small studies have proposed an increased prevalence of antinuclear antibody, antigliadin IgA, and anti-Saccharomyces cerevisiae antibodies in serum in patients with MC [Holstein et al 2006]. Scrutinizing a greater cohort of patients with MC with 11 different autoantibodies did not show any increased prevalence of autoantibodies in patients with MC compared with healthy controls Roth et al 2013b;Gustafsson et al 2013]. Recent research suggests an increased morbidity in a wide range of chronic diseases in patients with MC, irrespective of autoimmunity, including ischemic cardiovascular diseases, hypertension, asthma, and allergy [Roth et al 2013d].…”

Section: Autoimmunity and Comorbiditymentioning

confidence: 75%

New insights and challenges in microscopic colitis

Ohlsson

2014

Therap Adv Gastroenterol

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Microscopic colitis (MC) is described as an inflammatory bowel disease characterized by chronic, bloodless diarrhea with normal or close to normal endoscopic findings. Histopathological examination reveals two subtypes: collagenous colitis (CC) and lymphocytic colitis (LC), which are indistinguishable clinically. The disease debuts typically in middle-aged patients, but can occur at all ages, including children. A female predominance is found in both CC and LC, but is not confirmed by others in LC. The etiology is unclear, but the disease has been assumed to be of autoimmune origin. However, several etiologies may render a microscopic inflammation in the mucosa; this is a common, universal reaction to a variety of irritants in contact with the intestinal lumen. Furthermore, some patients with a microscopic inflammation in their colonic mucosa have no symptoms, or are suffering from constipation or abdominal pain, rather than diarrhea. Recently, a discussion was initiated calling into question the overdiagnosing of symptoms and pointing out the danger of exacerbating people's perception of their ailments, of weakening their eligibility in health insurance, of overprescription of drugs, and thus the increasing cost to the society of health care. In the light of this discussion, this review will highlight histopathological and clinical features of MC, and discuss the diagnosis and management of this disease. Perhaps, the intestinal mucosa has no other mode by which to react than an inflammatory response, irrespective of the presence or absence of autoimmunity. Thus, to better identify and classify subgroups of MC, and to clarify and correctly handle the inflammatory changes, this field of research stands to benefit from a review of the results and experience gained to date.

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“…The common serological inflammatory marker, such as C-Reactive Protein is usually normal or only slightly elevated in MC (Roth, Gustafsson, and Ohlsson 2013). However, the prevalence of antinuclear antibodies, antiSaccharomyces cerevisiae IgG antibodies, anti-thyroid peroxidase, anti-perinuclear neutrophil cytoplasmic antibodies and anti-glutamic acid decarboxylase was significantly higher compared to controls (Roth et al 2013)(Jauregui-Amezaga et al 2016) ) (Pisani et al 2017). Unfortunately, these antibodies do not have the potential to be used as a serological marker of MC, because they possess very low specificity and sensitivity (Roth et al 2013) (Pisani et al 2017).…”

Section: Laboratory Testsmentioning

confidence: 95%