Inflammatory bowel disease serology in Asia and the West

Lani Prideaux, Michael A Kamm, Peter De Cruz, Department of Gastroenterology, St Vincent's Hospital, Fitzroy 3065, Melbourne, Australia.
World Journal of Gastroenterology (Impact Factor: 2.37). 10/2013; 19(37):6207-6213. DOI: 10.3748/wjg.v19.i37.6207
Source: PubMed


To study serological antibodies in Caucasians and Asians, in health and inflammatory bowel disease (IBD), in Australia and Hong Kong (HK).
Anti-glycan antibodies [anti-chitobioside (ACCA), anti-laminaribioside (ALCA)], and anti-mannobioside (AMCA), anti-Saccharomyces cervisiae (gASCA); and atypical perinuclear anti-neutrophil cytoplasmic antibody (pANCA) were tested in IBD patients, their unaffected relatives, and healthy controls in Australia and HK (China). Antibody status (positive or negative) and titre was compared between subjects of different geography, ethnicity and disease state.
Ninety subjects were evaluated: 21 Crohn's disease (CD), 32 ulcerative colitis (UC), 29 healthy controls, and 8 IBD patient relatives. Forty eight subjects were Australian (29 Caucasian and 19 ethnic Han Chinese) and 42 were from HK (all Han Chinese). Caucasian CD patients had a significantly higher antibody prevalence of gASCA (67% vs 3%, P < 0.001), ALCA (44% vs 6%, P = 0.005), and AMCA (67% vs 15%, P = 0.002), whereas HK CD patients had a higher prevalence of only AMCA (58% vs 25%, P = 0.035), when compared with UC and healthy subjects in both countries. Caucasian CD had significantly higher gASCA prevalence (67% vs 0%, P < 0.001) and titre (median 59 vs 9, P = 0.002) than HK CD patients. Prevalence and titres of ALCA, ACCA and AMCA did not differ between CD in the two countries. Presence of at least one antibody was higher in Caucasian than HK CD patients (100% vs 58%, P = 0.045). pANCA did not differ between countries or ethnicity.
Serologic CD responses differ between HK Asian and Australian Caucasian patients. Different genetic, environmental or disease pathogenic factors may account for these differences.

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    • "In 1996, Vasiliauskas et al. suggested that pANCA identifies a subset of CD with a UC(ulcerative-colitis- ) like presentation [14], but this cannot be validated in an independent cohort [15]. Here, the pANCA testing of the patient was repeatedly positive without a UClike presentation, suggesting the presence of genetic heterogeneity in pANCA as a biomarker for the disease, which was also involved in the data shown by Prideaux et al. in 2013 [16]. However, serological markers seem to be unable to indicate disease activity according to the study by Rieder et al. [17]. "
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