Prevalence, significance and predictive value of antiphospholipid antibodies in Crohn’s disease

Sipeki, Nóra; Dávida, László; Palyu, Eszter; Altorjay, István; Hársfalvi, Jolán; Szalmas, Peter Antal; Szabó, Zoltán; Veres, Gábor; Shums, Zakera; Norman, Gary L.; Lakatos, László; Papp, Mária

doi:10.3748/wjg.v21.i22.6952

Cited by 21 publications

(20 citation statements)

References 48 publications

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“…We performed a cohort study among adult UC patients in a Hungarian tertiary IBD referral center (Gastroenterology Department of Institute of Medicine, University of Debrecen). The baseline clinical data regarding this cohort overlap with our previous studies [ 15 , 16 ], however hereby we present an extended follow up time with nearly 2 and a half years and re-evaluation of the outcomes. We used the same step by step thorough statistical evaluations; therefore the text appeared to reproduce information already reported in detail elsewhere.…”

Section: Methodsmentioning

confidence: 60%

“…Detailed clinical phenotypes were captured at inclusion. Clinical data were determined by thorough review of patients’ medical records, which had been collected in a uniform format described in detail in our previous studies [ 15 , 16 ]. Medical records that documented age at presentation, disease extent [ 18 ], presence of extraintestinal manifestations [EIM] and familial IBD, smoking habits, medication use, UC-related hospitalization due to disease activity, development of extensive disease (from E1/E2 to E3) and need for colectomy, were retrospectively analyzed for the period prior to the prospective follow-up.…”

Section: Methodsmentioning

confidence: 99%

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Significance of serological markers in the disease course of ulcerative colitis in a prospective clinical cohort of patients

et al. 2018

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Background & aimsTo determine the prognostic potential of classic and novel serologic antibodies regarding unfavorable disease course in a prospective ulcerative colitis (UC) patient cohort, since few and conflicting data are available in the literature regarding this matter.Methods187 consecutive patients were studied prospectively (median follow-up: 135 months) from a single referral IBD center in Hungary. Sera were tested for different IgA/IgG type autoantibodies (anti-neutrophil cytoplasmic [ANCA], anti-DNA-bound-lactoferrin [anti-LFS], anti-goblet cell [anti-GAB] and anti-pancreatic [PAB: anti-CUZD1 and anti-GP2)]) by indirect immunofluorescence technique and for anti-microbial (anti-Saccharomyces cerevisiae [ASCA] IgG/IgA and anti-OMP Plus™ IgA) antibodies by enzyme-linked immunosorbent assays.ResultsA total of 73.6%, 62.4% and 11.2% of UC patients were positive for IgA/IgG type of atypical perinuclear-ANCA, anti-LFS and anti-GAB, respectively. Occurrences of PABs were 9.6%, while ASCA IgA/IgG and anti-OMP IgA were 17.6% and 19.8%, respectively. Antibody status was stable over time. IgA type PABs were more prevalent in patients with primary sclerosing cholangitis (37.5% vs. 4.7% for anti-CUZD1 and 12.5% vs. 0% for anti-GP2, p<0.001 for both). IgA type ASCA and anti-CUZD1 antibodies were associated with higher risk of requirement for long-term immunosuppressant therapy in Kaplan-Meier analysis (pLogRank <0.01 for both). However, in multivariate Cox-regression analysis only ASCA IgA (HR: 2.74, 95%CI: 1.46–5.14, p<0.01) remained independent predictor. UC-related hospitalization due to disease activity was only associated with multiple antibody positivity (for 3 or more; HR 2.03 [95% CI: 1.16–3.56]; p = 0.013). None of the individual antibodies or their combination was associated with the risk of development of extensive disease or colectomy.ConclusionEven with low prevalence rates, present study gives further evidence to the role of certain antibodies as markers for distinct phenotype and disease outcome in UC. Considering the result of the multivariate analysis the novel antibodies investigated do not seem to be associated with poor clinical outcome in UC, only a classic antibody, IgA subtype ASCA remained an independent predictor of long-term immunosuppressive therapy.

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Section: Methodsmentioning

confidence: 60%

Section: Methodsmentioning

confidence: 99%

Significance of serological markers in the disease course of ulcerative colitis in a prospective clinical cohort of patients

et al. 2018

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“…CD is a chronic inflammatory disease of the gastrointestinal tract that particularly affects the terminal part of the ilium and colon. The disease has also an autoimmune component as the patients develop a variety of autoantibodies that target antigens such as pancreatic autoantigens, e.g., glycoprotein-2, CUB and zona pellucida-like domain-containing protein 1, GM-CSF, and phospholipids [19][20][21][22]. The significant positive association of activating KIR genes with CD suggests involvement of NK cells in the immunopathogenesis of this disease.…”

Section: Introductionmentioning

confidence: 99%

Phenotypic and Functional Changes in Peripheral Blood Natural Killer Cells in Crohn Disease Patients

Samarani

Sagala

Jantchou

et al. 2020

Mediators of Inflammation

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We investigated activation status, cytotoxic potential, and gut homing ability of the peripheral blood Natural Killer (NK) cells in Crohn disease (CD) patients. For this purpose, we compared the expression of different activating and inhibitory receptors (KIR and non-KIR) and integrins on NK cells as well as their recent degranulation history between the patients and age-matched healthy controls. The study was conducted using freshly obtained peripheral blood samples from the study participants. Multiple color flow cytometry was used for these determinations. Our results show that NK cells from treatment-naïve CD patients expressed higher levels of activating KIR as well as other non-KIR activating receptors vis-à-vis healthy controls. They also showed increased frequencies of the cells expressing these receptors. The expression of several KIR and non-KIR inhibitory receptors tended to decrease compared with the cells from healthy donors. NK cells from the patients also expressed increased levels of different gut-homing integrin molecules and showed a history of increased recent degranulation events both constitutively and in response to their in vitro stimulation. Furthermore, treatment of the patients tended to reverse these NK cell changes. Our results demonstrate unequivocally, for the first time, that peripheral blood NK cells in treatment-naïve CD patients are more activated and are more poised to migrate to the gut compared to their counterpart cells from healthy individuals. Moreover, they show that treatment of the patients tends to normalize their NK cells. The results suggest that NK cells are very likely to play a role in the immunopathogenesis of Crohn disease.

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“…Although a recent cohort study demonstrated the presence of aPLs was not associated with a risk of venous thrombotic events in CD patients, aPLs may have certain pathogenetic roles in thromboembolic disease. 13 Further study seems to be required to determine a pathogenetic role of aPLs in IBD patients with thromboembolic complications.…”

Section: Discussionmentioning

confidence: 99%

A case of ulcerative colitis presenting with cerebral venous thrombosis

et al. 2018

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Patients with inflammatory bowel disease (IBD) have been reported to have an increased risk of thromboembolism. Cerebral venous thrombosis (CVT) is a rare but serious extraintestinal manifestation of IBD. Due to its highly variable manifestation and low incidence, CVT is not usually readily recognized by physicians. Herein, we report a case of a 35-year-old male presenting with CVT associated with ulcerative colitis (UC). The patient was admitted with chief complaints of bloody diarrhea that had started 3 days prior. Sigmoidoscopy showed hyperemic and edematous mucosa, friability, and shallow ulcers from the sigmoid colon to the rectum suggestive of IBD. Three days later, the patient started complaining of a headache, and gradually developed a decreased level of consciousness. Magnetic resonance imaging of the brain revealed CVT with hemorrhagic infarctions. An angiogram was obtained to evaluate the extent of CVT, and anticoagulation therapy was initiated with intravenous heparin. During hospitalization, he was diagnosed with UC and treated with 5-aminosalicylic acid. After discharge, the patient was recovered without neurological deficit, and remission of UC was also obtained. The presence of headache or acute worsening of neurological status in a patient with IBD should alert the health professionals about the possibility of CVT.

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Prevalence, significance and predictive value of antiphospholipid antibodies in Crohn’s disease

Abstract: The present study demonstrated enhanced formation of APLAs in CD patients. However, presence of different APLAs were not associated with the clinical phenotype or disease course.

Cited by 21 publications

References 48 publications

Significance of serological markers in the disease course of ulcerative colitis in a prospective clinical cohort of patients

Significance of serological markers in the disease course of ulcerative colitis in a prospective clinical cohort of patients

Phenotypic and Functional Changes in Peripheral Blood Natural Killer Cells in Crohn Disease Patients

A case of ulcerative colitis presenting with cerebral venous thrombosis

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