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Antineutrophil cytoplasmic antibodies in inflammatory bowel disease

Clinical role and review of the literature

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Diseases of the Colon & Rectum

Abstract

PURPOSE: Perinuclear antineutrophil cytoplasmic antibodies have been found consistently in patients with ulcerative colitis; however, their pathogenetic and clinical role is still uncertain. In this study we tested the prevalence of perinuclear antineutrophil cytoplasmic antibodies in a large population of patients with ulcerative colitis and Crohn's disease, with particular attention to the possible correlation with clinical features. METHODS: Perinuclear antineutrophil cytoplasmic antibody reactivity was investigated with indirect immunofluorescence in 279 patients with ulcerative colitis, 110 patients with Crohn's disease, and 252 unrelated healthy subjects. RESULTS: Perinuclear antineutrophil cytoplasmic antibodies were found in 84 of 279 patients with ulcerative colitis (30 percent), 10 of 110 patients with Crohn's disease (9 percent), and 2 of 252 healthy subjects (<1 percent;P<0.001), respectively. Perinuclear antineutrophil cytoplasmic antibodies were significantly more frequent in patients with ulcerative colitis with higher relapse rate (43vs. 27 percent;P<0.002), and patients with Crohn's disease with colitis (27vs. 2.5 percent;P<0.0003). Perinuclear antineutrophil cytoplasmic antibodies were also significantly less frequent in patients with ulcerative colitis in remission (18vs. 34 percent;P<0.0025). CONCLUSIONS: In this study we confirm the relative specific of perinuclear antineutrophil cytoplasmic antibodies, either for ulcerative colitis or for Crohn's disease involving the colon. Perinuclear antineutrophil cytoplasmic antibodies were more frequently found in patients with ulcerative colitis with a more aggressive clinical behavior; however, their presence had a limited value in identifying homogeneous subgroups of patients in our population.

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References

  1. Satsangi J, Jewell DP, Rosenberg WM, Bell JI. Genetics of IBD. Gut 1994;35:696–700.

    Google Scholar 

  2. Saxon A, Shanahan F, Landers C, Ganz T, Targan SR. A distinct subset of antineutrophil cytoplasmic antibodies is associated with IBD. J Allergy Clin Immunol 1990;86:202–10.

    Google Scholar 

  3. Duerr RH, Targan SR, Landers CJ,et al. Neutrophil cytoplasmic antibodies: a link between primary sclerosing cholangitis and ulcerative colitis. Gastroenterology 1991;100:1385–91.

    Google Scholar 

  4. Seibold F, Weber P, Klein R, Berg PA, Wiedman KH. Clinical significance of antibodies against neutrophils in patients with IBD and primary sclerosing cholangitis. Gut 1992;33:657–62.

    Google Scholar 

  5. Shanahan F, Duerr RH, Rotter IJ,et al. Neutrophil antibodies in ulcerative colitis. Familial aggregation and genetic heterogeneity. Gastroenterology 1992;103:456–61.

    Google Scholar 

  6. Falk RJ, Jennette JC. Antineutrophil cytoplasmatic autoantibodies with specificity for myeloperoxidase in patients with systemic vasculitis and idiopathic necrotizing and crescentic glomerulonephritis. N Engl J Med 1988;318:1651–7.

    Google Scholar 

  7. Van Der Woude FJ, Rasmussen N, Lobatto S,et al. Antibodies against neutrophil and monocytes: a new tool for diagnosis and marker of disease activity in Wegener's granulomatosis. Lancet 1985;2:425–9.

    Google Scholar 

  8. Bansi DS, Chapman RW, Fleming KA. Prevalence and diagnostic role of antineutrophil cytoplasmic antibodies in IBD. Eur J Gastroenterol Hepatol 1996;8:881–5.

    Google Scholar 

  9. Lennard-Jones JE. Classification of IBD. Scand J Gastroenterol 1989;24(Suppl 170):2–6.

    Google Scholar 

  10. Powell-Tuck J, Day DW, Buckell NA, Wadsworth J, Lennard-Jones JE. Correlations between defined sigmoidoscopic appearances and other measures of disease activity in ulcerative colitis. Dig Dis Sci 1982;27:533–7.

    Google Scholar 

  11. Best WR, Becktel JM, Singleton JW, Kern F. Development of a Crohn's disease activity index. Gastroenterology 1976;70:439–44.

    Google Scholar 

  12. Boyum A. Separation of leucocytes from blood and bone marrow. Scand J Clin Lab Invest 1968;21:31–50.

    Google Scholar 

  13. Yang P, Bohr J, Tysk C, Danielsson D, Jarnerst G. Antineutrophil cytoplasmic antibodies in inflammatory bowel disease and collagenous colitis: no association with lactoferrin,β-glucuronidase, myeloperoxidase, or proteinase 3. Inflamm Bowel Dis 1996;2:173–7.

    Google Scholar 

  14. Broekroelofs J, Murder AH, Nelis GF, Westerweld BD, Tervaert Cohen JW, Kallenberg CG. Anti-neutrophils cytoplasmic antibodies (ANCA) in sera from patients with inflammatory bowel disease (IBD). Dig Dis Sci 1994;39:545–9.

    Google Scholar 

  15. Duerr RH, Targan SR, Landers CJ, Sutherland LR, Shanahan F. Antineutrophil cytoplasmic antibodies in ulcerative colitis. Gastroenterology 1991;100:1590–6.

    Google Scholar 

  16. Cambridge G, Rampton DS, Stevens TR, Mc Carthy DA, Kamm M, Leaker B. Anti-neutrophil antibodies in IBD: prevalence and diagnostic role. Gut 1992;33:668–74.

    Google Scholar 

  17. Hertevig E, Wieslander J, Johansson C, Wiik A, Nilsson A. Antineutrophil cytoplasmic antibodies in chronic inflammatory bowel disease. Scand J Gastroenterol 1995;30:693–8.

    Google Scholar 

  18. Yang P, Bohr J, Tysk C, Danielsson D, Jarnerot G. Antineutrophil cytoplasmic antibodies in inflammatory bowel disease and collagenous colitis: no association with lactoferrin,β-glucuronidase, myeloperoxidase, or proteinase 3. Inflamm Bowel Dis 1996;2:173–7.

    Google Scholar 

  19. Remaux D, Colombel JF, Heresbach D, Duclos B, Chaussade S, Belaiche J. Antineutrophil cytoplasmic antibodies in sera from patients after proctocolectomy for ulcerative colitis [abstract]. Gastroenterology 1993;104:A769.

    Google Scholar 

  20. Vecchi M, Gionchetti P, Bianchi MP,et al. p-ANCA and development of pouchitis in ulcerative colitis patients after proctocolectomy and ileoanal pouch anastomosis. Lancet 1994;344:886–7.

    Google Scholar 

  21. Rump JA, Roth M, Scholmerick J, Helfesrieder R, Ludemann J, Gross WL. A new type of ANCA in sera of patients with ulcerative colitis: effects of therapy and disease severity on serum titer. Immunol Infect 1992;20:16–8.

    Google Scholar 

  22. Oudkerk Pool M, Ellerbroek PM, Ridwan BV,et al. Serum antineutrophil cytoplasmic autoantibodies in IBD are mainly associated with ulcerative colitis. A correlation study between perinuclear antineutrophil cytoplasmic autoantibodies and clinical parameters, medical and surgical treatment. Gut 1993;34:46–50.

    Google Scholar 

  23. Sandborn WJ, Landers CJ, Tremaine WJ, Targan SR. Antineutrophil cytoplasmic antibodies correlates with chronic pouchitis after ileal-pouch-anal anastomosis. Am J Gastroenterol 1995;90:740–7.

    Google Scholar 

  24. Seibold F, Slametschka D, Gregor M, Weber P. Neutrophil autoantibodies a genetic marker in primary sclerosing cholangitis and ulcerative colitis. Gastroenterology 1994;107:532–6.

    Google Scholar 

  25. Yang H, Rotter JI, Toyoda H, Landers C, Tyan D, Mc Elree CK, Targan SR. Ulcerative colitis: a genetically heterogeneous disorder defined by genetic (HLA class II) and subclinical (antineutrophil cytoplasmic antibodies) markers. J Clin Invest 1993;92:1080–4.

    Google Scholar 

  26. Yang H, Shohat T, Rotter JI. The genetics of IBD. In: MacDermott RP, Stensonn WF, eds. Inflammatory bowel disease. New York: Elsevier Science Publishing, 1992;17–51.

    Google Scholar 

  27. Toyoda H, Wang SJ, Yang H,et al. Distinct associations of HLA class II genes with inflammatory bowel disease. Gastroenterology 1993;104:741–8.

    Google Scholar 

  28. Perri F, Annese V, Piepoli A,et al. HLA antigens and pANCA define ulcerative colitis as a genetically heterogeneous disorder. Ital J Gastroenterol Hepatol 1998;30:56–61.

    Google Scholar 

  29. Annese V, Piepoli A, Andriulli A,et al. Polymorphism of motilin gene in patients with Crohn's disease. Dig Dis Sci 1998;43:715–9.

    Google Scholar 

  30. Shanahan F. Neutrophil antibodies in IBD: are they important [editorial]? Gastroenterology 1994;107:586–9.

    Google Scholar 

  31. Sandborn WJ, Landers CJ, Tremaine WJ, Targan SR. Association of antineutrophil cytoplasmic antibodies with resistance to treatment of left side ulcerative colitis. Results of a pilot study. Mayo Clin Proc 1996;71:431–6.

    Google Scholar 

  32. Esteve M, Mallolas J, Klaassen J,et al. Antineutrophil cytoplasmic antibodies in sera from colectomised ulcerative colitis patients and its relation to the presence of pouchitis. Gut 1996;38:894–8.

    Google Scholar 

  33. Lindgren S, Claes-Henrik F, Lindhagen T, Starck M, Stewenius J, Nassberger L. Low prevalence of antineutrophil cytoplasmic antibodies in ulcerative colitis patients with long-term remission. Eur J Gastroenterol Hepatol 1995;7:563–8.

    Google Scholar 

  34. Vasiliauskas EA, Plevy SE, Landers CJ,et al. Perinuclear antineutrophil cytoplasmic antibodies in patients with Crohn's disease define a clinical subgroup. Gastroenterology 1996;100:1810–9.

    Google Scholar 

  35. Rump JA, Scholmerich J, Gross V,et al. A new type of perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA) in active ulcerative colitis but not in Crohn's disease. Immunobiology 1990 181;406–13.

    Google Scholar 

  36. Romas E, Paspaliaris B, d'Apice AJ, Elliott PR. Autoantibodies to neutrophil cytoplasmic (ANCA) and endothelial cell surface antigens (AECA) in chronic inflammatory bowel disease. Aust N Z J Med 1992;22:652–9.

    Google Scholar 

  37. Schlenker T, Apenberg S, Raedsch R, Andrassy K, Plachky J, Kommerell B, Antineutrophil cytoplasmic antibodies in chronic inflammatory bowel diseases. Dtsch Med Wochenschr 1992;117:1463–8.

    Google Scholar 

  38. Proujansky R, Fawcett PT, Gibney KM, Treem WR, Hyams JS. Examination of anti-neutrophil cytoplasmic antibodies in childhood inflammatory bowel disease. J Pediatr Gastroenterol Nutr 1993;17:193–7.

    Google Scholar 

  39. Mulder AH, Broekroelofs J, Horst G, Limburg PC, Nelis GF, Kallenberg CG. Antineutrophil antibodies in inflammatory bowel disease recognize different antigens. Adv Exp Med Biol 1993;336:519–22.

    Google Scholar 

  40. Deusch K, Oberstadt K, Schaedel W, Weber M, Classen M. p-ANCA as a diagnostic marker in ulcerative colitis. Adv Exp Med Biol 1993;336:527–31.

    Google Scholar 

  41. Vecchi M, Bianchi MB, Sinico RA,et al. Antibodies to neutrophil cytoplasm in Italian patients with ulcerative colitis: sensitivity, specificity and recognition of putative antigens. Digestion 1994;55:34–9.

    Google Scholar 

  42. Lamproye A, Belaiche J, Louis E, Salmon J, Mahieu. Antineutrophil cytoplasmic antibodies (ANCA) in inflammatory diseases of the digestive tract. Acta Gastroenterol Belg 1994;57:171–6.

    Google Scholar 

  43. Oudkerk Pool M, Bouma G, Meuwissen SG,et al. Serological markers to differentiate between ulcerative colitis and Crohn's disease. J Clin Pathol 1995;48:346–50.

    Google Scholar 

  44. Aisenberg J, Wagreich J, Shim J,et al. Perinuclear antineutrophil cytoplasmic antibody and refractory pouchitis. A case-control study. Dig Dis Sci 1995 40;1866–72.

    Google Scholar 

  45. Aitola P, Miettinen A, Mattila A, Matikainen M, Soppi E. Effect of proctocolectomy on serum antineutrophil cytoplasmic antibodies in patients with chronic ulcerative colitis. J Clin Pathol 1995l;48:645–7.

    Google Scholar 

  46. Castellino F, Rosina F, Bansi DS,et al. Anti-neutrophil cytoplasmic antibodies in inflammatory bowel disease: do they recognize different subsets of a heterogeneous disease? Eur J Gastroenterol Hepatol 1995;7:859–64.

    Google Scholar 

  47. Abad E, Tural C, Mirapeix E, Cuxart A. Relationship between ANCA and clinical activity in inflammatory bowel disease: variation in prevalence of ANCA and evidence of heterogeneity. J Autoimmun 1997;10:175–80.

    Google Scholar 

  48. Olives JP, Breton A, Hugot JP,et al. Antineutrophil cytoplasmic antibodies in children with inflammatory bowel disease: prevalence and diagnostic value. J Pediatr Gastroenterol Nutr 1997;25:142–8.

    Google Scholar 

  49. Freeman HJ. Atypical perinuclear antineutrophil cytoplasmic antibodies in patients with Crohn's disease. Can J Gastroenterol 1997;11:689–93.

    Google Scholar 

  50. Satsangi J, Landers CJ, Welsh KI, Koss K, Targan S, Jewell DP. The presence of anti-neutrophil antibodies reflects clinical and genetic heterogeneity within inflammatory bowel disease. Inflamm Bowel Dis 1998;4:18–26.

    Google Scholar 

  51. Yasuda N, Thomas P, Ellis H, Herbst F, Nicholls J, Ciclitira P. Perinuclear anti-neutrophil cytoplasmic antibodies in ulcerative colitis after restorative proctocolectomy do not correlate with the presence of pouchitis. Scand J Gastroenterol 1998;33:509–13.

    Google Scholar 

  52. Kull K, Salupere R, Uibo R, Ots M, Salupere V. Antineutrophil cytoplasmic antibodies in Estonian patients with inflammatory bowel disease. Prevalence and diagnostic role. Hepatogastroenterology 1998;45:2132–7.

    Google Scholar 

  53. Roozendaal C, Pogany K, Horst G,et al. Does analysis of the antigenic specificities of anti-neutrophil cytoplasmic antibodies contribute to their clinical significance in the inflammatory bowel diseases? Scand J Gastroenterol 1999;34:1123–31.

    Google Scholar 

  54. Roozendaal C, Pogany K, Hummel EJ,et al. Titres of anti-neutrophil cytoplasmic antibodies in inflammatory bowel disease are not related to disease activity. Q J Med 1999;92:651–8.

    Google Scholar 

  55. Elzouki AN, Eriksson S, Lofberg R, Nassberger L, Wieslander J, Lindgren S. The prevalence and clinical significance of alpha 1-anitryosin deficiency and ANCA specificities (proteinase 3, BPI) in patients with ulcerative colitis. Inflamm Bowel Dis 1999;5:246–52.

    Google Scholar 

  56. Taddei C, Audrain MA, Reumaux D,et al. Alpha1-antitrypsin phenotypes and anti-neutrophil cytoplasmic autoantibodies in inflammatory bowel disease. Eur J Gastroenterol Hepatol 1999;11:1293–9.

    Google Scholar 

  57. Roozendaal C, Kallenberg CG. Are anti-neutrophil cytoplasmic antibodies (ANCA) clinically useful in inflammatory bowel disease? Clin Exp Immunol 1999;116:206–13.

    Google Scholar 

  58. Panaccione R, Sandborn WJ. Is antibody testing for inflammatory bowel disease clinically useful? Gastroenterology 1999;116:1001–8.

    Google Scholar 

  59. Main J, McKenzie H, Yeaman GR,et al. Antibody to Saccharomyces cerevisiae (baker's yeast) in Crohn's disease. Br Med J 1988;297:1105–6.

    Google Scholar 

  60. Giaffer MH, Clark A, Holdsworth CD. Antibodies to Saccharomyces cerevisiae in patients with Crohn's disease and their possible pathogenic importance. Gut 1992;33:1071–5.

    Google Scholar 

  61. Quinton JF, Sendid B, Reumaux D,et al. Anti-Saccharomyces cerevisiae mannan combined with antineutrophil antibodies in inflammatory bowel disease: prevalence and diagnostic role. Gut 1998;42:788–91.

    Google Scholar 

  62. Hoffemberg EJ, Fidanza S, Sauaia A. Serologic testing for inflammatory bowel disease. J Pediatr 1999;134:447–52.

    Google Scholar 

  63. Ruemmele FM, Targan SR, Levy G, Dubinsky M, Braun J, Seidman EG. Diagnostic accuracy of serological assays in pediatric inflammatory bowel disease. Gastroenterology 1998;115:822–9.

    Google Scholar 

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Lombardi, G., Annese, V., Piepoli, A. et al. Antineutrophil cytoplasmic antibodies in inflammatory bowel disease. Dis Colon Rectum 43, 999–1007 (2000). https://doi.org/10.1007/BF02237367

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