Serological Antibodies in Inflammatory Bowel Disease: A Systematic Review

Abstract

The diagnosis of inflammatory bowel disease (IBD) is traditionally based on a combination of clinical, endoscopic, histological, and radiological criteria. However, further testing is needed in cases of diagnostic uncertainty and in predicting disease course. This systematic review focuses on the potential for 10 serological antibodies to fill these roles: pANCA, ASCA, anti-OmpC, anti-CBir1, anti-I2, ALCA, ACCA, AMCA, anti-L, and anti-C. We discuss their prevalence in IBD and health; their role in disease diagnosis and risk stratification; their stability over time; their presence in unaffected relatives; their association with genetic variants; and differences across ethnic groups. Serological antibodies have some role in primary diagnosis and in differentiating between Crohn's disease and ulcerative colitis. In indeterminate colitis, preoperative measurement of serological antibodies can help to predict the likelihood of complications among patients undergoing pouch surgery. The combined presence and magnitude of a large panel of antibodies appear to be of value in predicting disease progression. There is currently insufficient evidence to recommend the use of antibody testing to predict responses to treatment or surgery in patients with IBD.

Detection of Crohn Disease in Patients with Spondyloarthropathy: The SpACE Capsule Study

“…Antibodies targeting bacterial antigens have been extensively evaluated for diagnosis, classification, and prognostication in IBD 31 . The prevalence of positive IBD-related serological biomarkers [anti-Saccharomyces cerevisiae antibodies (ASCA) IgA and IgG, anti-outer membrane porin C of E. coli (OmpC), and anti-CBir-1] is higher in SpA than controls 32,33 .…”

Bio-Markers of Inflammatory Bowel Disease: Past, Present, and Future

“…Furthermore, the difference between the two diseases cannot be accounted for on an anatomical basis, as increased titers of ASCAs were not confined to patients with CD of the small bowel. ASCAs are antibodies against mannan in cell wall of S. cerevisiae [24] with high specificity of 90-100% in CD but relatively low sensitivity of 31%-45% [25]. Finally, it should be noted that ASCA and atypical P-ANCA markers are not useful for IBD screening.…”

Clinical Utility of Anti- Granulocyte Macrophage-Colony Stimulating Factor Antibodies in Inflammatory Bowel Disease

“…Several antibodies have been identified in IBD but their role in prognosis and therapeutic monitoring is still unclear [7][8][9]. Because of low specificity and sensitivity of specific antibodies detection, lack of target values, no national, European or international guideline recommends the detection of antibodies for the diagnosis or prognosis and therapeutic monitoring of IBD to date.…”