Our Initial Experience with Examination of Antibodies against Saccharomyces cerevisiae (ASCA) in Patients with Primary Non-specific Inflammations of the Bowel

Overview

Introduction:
Inflammatory bowel diseases (IBD), with Crohn's disease (CD) and ulcerative colitis (UC) as the two main disorders, is a heterogeneous group of diseases of unknown etiology. Actually we have no ideal disease marker, to identify people at risk of the disease, which can differentiate CD from UC, be highly specific for CD or UC and easily applicable in routine laboratory praxis. Aims: determine the clinical significance of serological testing p-ANCA and ASCA in patients with IBD.Methods: p-ANCA in IgG isotype were detected by indirect fluorescence assay on human ethanol-fixed granulocytes, ASCA antibodies in IgG and IgA isotypes were determined by ELISA with mannan as a target antigen.Results: p-ANCA and ASCA were studied in a group of 86 patients (38 CD, 26 UC, 3 non-inflammatory gastrointestinal disorder, 19 health controls). P-ANCA was associated with UC in 46%. ASCA was associated with CD in 76%. Specificity of ANCA for UC compared to healthy controls was 100%, specificity of ASCA for CD compared to healthy controls was 89.5%.Conclusion: although the Senzitivity of ASCA and p-ANCA is low, their specificity is high, especially when combining these two markrs. We think that combined assay for ASCA and p-ANCA is more useful in IBD.

Key words:
inflammatory bowel disease - Crohn's disease - ulcerative colitis - Saccharomyces cerevisiae - ASCA - p-ANCA.