Optimising the diagnostic value of Anti-Saccharomyces cerevisiae-antibodies (ASCA) in Crohn’s disease
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Anti-Saccharomyces cerevisiae-antibodies (ASCA) are used to discriminate Crohn’s disease (CD) from ulcerative colitis (UC). ASCA tests are not standardised and different methods for ASCA detection exist. This study was undertaken to compare ASCA tests and to clarify their diagnostic value.
One hundred and two sera from CD patients, 53 from UC patients, and 50 sera from normal controls were examined for ASCA IgA and ASCA IgG using four different ELISA (Aesku.lab, Inova, Euroimmun, and Medipan) and indirect immunofluorescence (Euroimmun). Sensitivity, specificity, and positive and negative predictive values (PPV and NPV) for CD in this population were determined. Agreement between tests was expressed by kappa statistics.
The presence of either ASCA IgA or ASCA IgG had a PPV between 77 and 88%. Only the combined presence of ASCA IgA and ASCA IgG had a specificity which was constantly above 90%. Sensitivity, specificity, PPV, and NPV were then: Inova: 53, 97, 95, and 68%; Euroimmun ELISA: 46, 97, 94, and 66%; Aesku.lab: 50, 97, 94, and 66%; Medipan: 30, 98, 94, and 59%; indirect immunofluorescence: 51, 97, 94, and 66%. Agreement between ELISA test results of the Aesku.lab, Euroimmun, Medipan IgA and Inova systems was good (kappa: 0.63–0.79); between the Medipan IgG ELISA or indirect immunofluorescence and the others, it was lower (kappa: 0.33–0.6). If both ASCA IgA and ASCA IgG were detected by indirect immunofluorescence as well as ELISA, specificity for CD increased to >99% at a sensitivity of 23–38%.
The combined detection of ASCA IgA and ASCA IgG by indirect immunofluorescence as well as ELISA may optimise the discrimination of CD from UC.
- Quinton JF, Sendid B, Reumaux D, Duthilleul P, Cortot A, Grandbastien B, Charrier G, Targan SR, Colombel JF, Poulain D (1998) Anti-Saccharomyces cerevisiae mannan antibodies combined with antineutrophil cytoplasmic autoantibodies in inflammatory bowel disease: prevalence and diagnostic role. Gut 42:788–791
- Peeters M, Joossens S, Vermeire S, Vlietinck R, Bossuyt X, Rutgeerts P (2001) Diagnostic value of Anti-Saccharomyces cerevisiae and antineutrophil cytoplasmic autoantibodies in inflammatory bowel disease. Am J Gastroenterol 96:730–734 CrossRef
- Sandborn WJ, Loftus EV, Colombel JF, Fleming KA, Seibold F, Homburger HA, Sendid B, Chapman RW, Tremaine WJ, Kaul DK, Wallace J, Harmsen WS, Zinsmeister AR, Targan SR (2001) Evaluation of serologic disease markers in a population-based cohort of patients with ulcerative colitis and Crohn’s disease. Inflamm Bowel Dis 7:192–201 CrossRef
- Koutroubakis IE, Petinaki E, Mouzas IA, Vlachonikolis IG, Anagnostopoulou E, Castanas E, Maniatis AN, Kouroumalis EA (2001) Anti-Saccharomyces cerevisiae mannan antibodies and antineutrophil cytoplasmic autoantibodies in Greek patients with inflammatory bowel disease. Am J Gastroenterol 96:449–454 CrossRef
- Moore MM, Fabricatorian D, Selby WS (2002) Assessment and relevance of enzyme-linked immunosorbent assay for antibodies to Saccharomyces cerevisiae in Australian patients with inflammatory bowel disease. Intern Med J 32:349–352 CrossRef
- Joossens S, Reinisch W, Vermeire S, Sendid B, Poulain D, Peeters M, Geboes K, Bossuyt X, Vandewalle P, Oberhuber G, Vogelsang H, Rutgeerts P, Colombel JF (2002) The value of serologic markers in indeterminate colitis: a prospective follow-up study. Gastroenterology 122:1242–1247
- Folwaczny C, Noehl N, Endres SP, Loeschke K, Fricke H (1998) Antineutrophil and pancreatic autoantibodies in first-degree relatives of patients with inflammatory bowel disease. Scand J Gastroenterol 33:523–528 CrossRef
- Seibold F, Weber P, Klein R, Berg PA, Wiedmann KH (1992) Clinical significance of antibodies against neutrophils in patients with inflammatory bowel disease and primary sclerosing cholangitis. Gut 33:657–662
- Ruemmele FM, Targan SR, Levy G, Dubinsky M, Braun J, Seidman EG (1998) Diagnostic accuracy of serological assays in pediatric inflammatory bowel disease. Gastroenterology 115:822–829
- Kull K, Salupere R, Uibo R, Ots M, Salupere V (1998) Antineutrophil cytoplasmic antibodies in Estonian patients with inflammatory bowel disease. Prevalence and diagnostic role. Hepatogastroenterology 45:2132–2137
- Seibold F, Weber P, Schöning A, Mörk H, Goppel S, Scheurlen M (1996) Neutrophil antibodies (pANCA) in chronic liver disease and inflammatory bowel disease: do they react with different antigens? Eur J Gastroenterol Hepatol 8:1095–1100
- Vasiliauskas EA, Kam LY, Karp LC, Gaienne J, Yang H, Targan SR (2000) Marker antibody expression stratifies Crohn’s disease into immunologically homogeneous subgroups with distinct clinical characteristics. Gut 47:487–496 CrossRef
- Klebl FH, Bataille F, Bertea CR, Herfarth H, Hofstädter F, Schölmerich J, Rogler G (2003) Association of Vienna classification subtypes of Crohn’s disease with pANCA and ASCA. Inflamm Bowel Dis 9:302–307 CrossRef
- Bernstein CN, Orr K, Blanchard JF, Sargent M, Workman D (2001) Development of an assay for antibodies to Saccharomyces cerevisiae: easy, cheap and specific for Crohn’s disease. Can J Gastroenterol 15:499–504
- Seibold F, Stich O, Hufnagl R, Kamil S, Scheurlen M (2001) Anti-Saccharomyces cerevisiae antibodies in inflammatory bowel disease: a family study. Scand J Gastroenterol 36:196–201 CrossRef
- Glas J, Török HP, Vilsmaier F, Herbinger KH, Hoelscher M, Folwaczny C (2002) Anti-Saccharomyces cerevisiae antibodies in patients with inflammatory bowel disease and their first-degree relatives: potential clinical value. Digestion 66:173–177 CrossRef
- Linskens RK, Mallant-Hent RC, Groothuismink ZMA, Bakker-Jonges LE, van de Merwe JP, Hooijkaas H, von Blomberg BME, Meuwissen SGM (2002) Evaluation of serological markers to differentiate between ulcerative colitis and Crohn’s disease: pANCA, ASCA and agglutinating antibodies to anaerobic coccoid rods. Eur J Gastroenterol Hepatol 14:1013–1018 CrossRef
- Vermeire S, Joossens S, Peeters M, Monsuur F, Marien G, Bossuyt X, Groenen P, Vlietinck R, Rutgeerts P (2001) Comparative study of ASCA (Anti-Saccharomyces cerevisiae antibody) assays in inflammatory bowel disease. Gastroenterology 120:827–833
- Optimising the diagnostic value of Anti-Saccharomyces cerevisiae-antibodies (ASCA) in Crohn’s disease
International Journal of Colorectal Disease
Volume 19, Issue 4 , pp 319-324
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- Crohn’s disease
- Indirect immunofluorescence
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- Author Affiliations
- 1. Department of Internal Medicine I, University of Regensburg, 93042, Regensburg, Germany
- 2. Institute of Pathology, University of Regensburg, Regensburg, Germany