Digestive Diseases and Sciences

, Volume 56, Issue 3, pp 812–818 | Cite as

Anti-Alpha-Enolase Antibody as a Serologic Marker and Its Correlation with Disease Severity in Intestinal Behçet’s Disease

  • Sung Jae Shin
  • Byung Chang Kim
  • Tae Il Kim
  • Sang Kil Lee
  • Kwang Hoon Lee
  • Won Ho Kim
Original Article

Abstract

Background

Intestinal Behçet’s disease (BD) is a chronic inflammatory bowel disease, as are Crohn’s disease (CD) and ulcerative colitis (UC). But unlike CD and UC, serologic markers for intestinal BD are not well known. Recently, anti-α-enolase antibody (AAEA) has been detected in sera from BD patients.

Aims

The aim of this study was to evaluate the prevalence of AAEA in intestinal BD and its clinical correlations.

Methods

The study sample included 80 patients with intestinal BD and 23 healthy controls. IgM AAEA was detected by ELISA. The positivity of IgM AAEA was defined as an optical density greater than three standard deviations above the mean of the control sera. Other parameters, such as demographic information, subtype of BD, colonoscopic findings, disease severity and treatment modality, were analyzed retrospectively.

Results

The prevalence of IgM AAEA was 67.5% in intestinal BD and 0% in the control group. The positivity rate of IgM AAEA was higher in complete or incomplete BD than in suspected BD (77.5% vs. 51.6%, P = 0.016). The mean HBI score was higher in antibody positive patients than in antibody negative patients (5.60 vs. 4.61, P = 0.003). The cumulative probability of steroid use for aggravation of intestinal and extra-intestinal symptoms was higher in antibody positive patients than in antibody negative patients (P = 0.012). The number of patients with systemic involvement was higher in the AAEA positive group than in the negative group.

Conclusions

Monitoring IgM AAEA may be helpful for diagnosis of intestinal BD and could be used to predict clinical course and disease severity.

Keywords

Anti-α-enolase antibody Disease severity Intestinal Behçet’s disease Serologic marker 

References

  1. 1.
    Kaklamani VG, Vaiopoulos G, Kaklamanis PG. Behçet’s disease. Semin Arthritis Rheum. 1998;27:197–217.CrossRefPubMedGoogle Scholar
  2. 2.
    Sakane T, Takeno M, Suzuki N, Inaba G. Behçet’s disease. N Engl J Med. 1999;341:1284–1291.CrossRefPubMedGoogle Scholar
  3. 3.
    Yurdakul S, Hamuryudan V, Yazici H. Behçet’s disease. Curr Opin Rheumatol. 2004;16:38–42.CrossRefPubMedGoogle Scholar
  4. 4.
    Saxon A, Shanahan F, Landers C, Ganz T, Targan S. A distinct subset of antineutrophil cytoplasmic antibodies is associated with inflammatory bowel disease. J Allergy Clin Immunol. 1990;86:202–210.CrossRefPubMedGoogle Scholar
  5. 5.
    Ruemmele FM, Targan SR, Levy G, Dubinsky M, Braun J, Seidman EG. Diagnostic accuracy of serological assays in pediatric inflammatory bowel disease. Gastroenterology. 1998;115:822–829.CrossRefPubMedGoogle Scholar
  6. 6.
    Peeters M, Joossens S, Vermeire S, Vlietinck R, Bossuyt X, Rutgeerts P. Diagnostic value of anti-Saccharomyces cerevisiae and antineutrophil cytoplasmic autoantibodies in inflammatory bowel disease. Am J Gastroenterol. 2001;96:730–734.CrossRefPubMedGoogle Scholar
  7. 7.
    Quinton JF, Sendid B, Reumaux D, et al. Anti-Saccharomyces cerevisiae mannan antibodies combined with antineutrophil cytoplasmic autoantibodies in inflammatory bowel disease: prevalence and diagnostic role. Gut. 1998;42:788–791.CrossRefPubMedGoogle Scholar
  8. 8.
    Sendid B, Colombel JF, Jacquinot PM, et al. Specific antibody response to oligomannosidic epitopes in Crohn’s disease. Clin Diagn Lab Immunol. 1996;3:219–226.PubMedGoogle Scholar
  9. 9.
    Adler Y, Salozhin K, Tongueze M, Shoenfeld Y, Youinou P. Anti-endothelial cell antibodies: a need for standardization. Lupus. 1994;3:77–84.CrossRefPubMedGoogle Scholar
  10. 10.
    Meroni PL, Khamashta MA, Youinou P, Shoenfeld Y. Mosaic of anti-endothelial antibodies. Review of the first international workshop on anti-endothelial antibodies, clinical and pathological significance. Lupus. 1995;4:95–99.CrossRefPubMedGoogle Scholar
  11. 11.
    Aydintug AO, Tokgoz G, D’Cruz DP, et al. Antibodies to endothelial cells in patients with Behçet’s disease. Clin Immunol Immunopathol. 1993;67:157–162.CrossRefPubMedGoogle Scholar
  12. 12.
    Lee KH, Bang D, Choi ES, Chun WH, Lee ES, Lee S. Presence of circulating antibodies to a disease specific antigen on cultured human dermal microvascular endothelial cells in patients with Behçet’s disease. Arch Dermatol Res. 1999;291:374–381.CrossRefPubMedGoogle Scholar
  13. 13.
    Lee KH, Chung HS, Kim HS, et al. Human alpha-enolase from endothelial cells as a target antigen of anti-endothelial cell antibody in Behçet’s disease. Arthritis Rheum. 2003;48:2025–2035.CrossRefPubMedGoogle Scholar
  14. 14.
    Mizushima Y, Inaba G, Mimura Y. Diagnostic criteria for Behçet’s disease in 1987, and guideline for treating Behçet’s disease. Saishin Igaku. 1988;43:382–391. (in Japanese).Google Scholar
  15. 15.
    International Study Group for Behçet's Disease. Criteria for diagnosis of Behçet’s disease. Lancet. 1990;335:1078–1080.Google Scholar
  16. 16.
    Lee CR, Kim WH, Cho YS, et al. Colonoscopic findings in intestinal Behçet’s disease. Inflamm Bowel Dis. 2001;7:243–249.CrossRefPubMedGoogle Scholar
  17. 17.
    Chung SY, Ha HK, Kim JH, et al. Radiologic findings of Behçet’s syndrome involving the gastrointestinal tract. Radiographics. 2001;21:911–924.PubMedGoogle Scholar
  18. 18.
    Pratesi F, Moscato S, Sabbatini A, Chimenti D, Bombardieri S, Migliorini P. Autoantibodies specific for alpha-enolase in systemic autoimmune disorders. J Rheumatol. 2000;27:109–115.PubMedGoogle Scholar
  19. 19.
    Pancholi V, Fischetti VA. Alpha-enolase, a novel strong plasmin(ogen) binding protein on the surface of pathogenic streptococci. J Biol Chem. 1998;273:14503–14515.CrossRefPubMedGoogle Scholar
  20. 20.
    Pancholi V. Multifunctional alpha-enolase: its role in diseases. Cell Mol Life Sci. 2001;58:902–920.CrossRefPubMedGoogle Scholar
  21. 21.
    Fontan PA, Pancholi V, Nociari MM, Fischetti VA. Antibodies to streptococcal surface enolase react with human alpha-enolase: implications in poststreptococcal sequelae. J Infect Dis. 2000;182:1712–1721.CrossRefPubMedGoogle Scholar
  22. 22.
    Iida H, Yahara I. Yeast heat-shock protein of Mr 48,000 is an isoprotein of enolase. Nature. 1985;315:688–690.CrossRefGoogle Scholar
  23. 23.
    Gitlits VM, Toh BH, Sentry JW. Disease association, origin, and clinical relevance of autoantibodies to the glycolytic enzyme enolase. J Investig Med. 2001;49:138–145.CrossRefPubMedGoogle Scholar
  24. 24.
    Saulot V, Vittecoq O, Charlionet R, et al. Presence of autoantibodies to the glycolytic enzyme alpha-enolase in sera from patients with early rheumatoid arthritis. Arthritis Rheum. 2002;46:1196–1201.CrossRefPubMedGoogle Scholar
  25. 25.
    Roozendaal C, Zhao MH, Horst G, et al. Catalase and alpha-enolase: two novel granulocyte autoantigens in inflammatory bowel disease (IBD). Clin Exp Immunol. 1998;112:10–16.CrossRefPubMedGoogle Scholar
  26. 26.
    Lee S. Diagnostic criteria of Behçet’s disease: problems and suggestions. Yonsei Med J. 1997;38:365–369.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Sung Jae Shin
    • 1
  • Byung Chang Kim
    • 1
  • Tae Il Kim
    • 1
  • Sang Kil Lee
    • 1
  • Kwang Hoon Lee
    • 2
  • Won Ho Kim
    • 1
  1. 1.Department of Internal Medicine, Institute of GastroenterologyYonsei University College of MedicineSeoulKorea
  2. 2.Department of DermatologyYonsei University College of MedicineSeoulKorea

Personalised recommendations