Amy L Hamilton1,2, Michael A Kamm1,2, Peter De Cruz1,2,3, Emily K Wright1,2, Fabiyola Selvaraj4, Fred Princen4, Alexandra Gorelik5, Danny Liew6, Ian C Lawrance7,8,9,10, Jane M Andrews11,12, Peter A Bampton13, Miles P Sparrow14, Timothy H Florin15,16, Peter R Gibson14,17, Henry Debinski18, Richard B Gearry19, Finlay A Macrae20,21, Rupert W Leong22, Ian Kronborg23, Graham Radford-Smith24,25, Warwick Selby26, Sally J Bell1,2, Steven J Brown1, William R Connell1. 1. Department of Gastroenterology, St Vincent's Hospital, Melbourne, Victoria, Australia. 2. Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia. 3. Austin Health, Melbourne, Victoria, Australia. 4. Prometheus Laboratories, San Diego, California, USA. 5. Melbourne EpiCentre, University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia. 6. Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Victoria, Australia. 7. School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia. 8. Centre for Inflammatory Bowel Diseases, Saint John of God Hospital, Subiaco, Western Australia, Australia. 9. Harry Perkins Institute for Medical Research, Nedlands, Western Australia, Australia. 10. Fiona Stanley Hospital, Perth, Western Australia, Australia. 11. Department of Gastroenterology and Hepatology, University of Adelaide, Adelaide, South Australia, Australia. 12. Royal Adelaide Hospital, Adelaide, South Australia, Australia. 13. Department of Gastroenterology and Hepatology, Flinders Medical Centre and Flinders University, Adelaide, South Australia, Australia. 14. Department of Gastroenterology, Alfred Health, Melbourne, Victoria, Australia. 15. Immunity Infection and Inflammation Program, Mater Research Institute-University of Queensland, and School of Medicine, University of Queensland, Brisbane, Queensland, Australia. 16. Translational Research Institute, Woolloongabba, Queensland, Australia. 17. Department of Gastroenterology, Monash University, Melbourne, Victoria, Australia. 18. Melbourne Gastrointestinal Investigation Unit, Cabrini Hospital, Melbourne, Victoria, Australia. 19. Department of Medicine, University of Otago, Christchurch, New Zealand. 20. Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia. 21. Department of Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Melbourne, Victoria, Australia. 22. Gastroenterology and Liver Services, Concord and Bankstown Hospitals and University of New South Wales, Sydney, New South Wales, Australia. 23. Department of Gastroenterology, Western Hospital, Melbourne, Victoria, Australia. 24. Department of Gastroenterology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia. 25. IBD Group Queensland Institute of Medical Research, University of Queensland, Brisbane, Queensland, Australia. 26. AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Abstract
BACKGROUND AND AIM: Disease recurs frequently after Crohn's disease resection. The role of serological antimicrobial antibodies in predicting recurrence or as a marker of recurrence has not been well defined. METHODS: A total of 169 patients (523 samples) were prospectively studied, with testing peri-operatively, and 6, 12 and 18 months postoperatively. Colonoscopy was performed at 18 months postoperatively. Serologic antibody presence (perinuclear anti-neutrophil cytoplasmic antibody [pANCA], anti-Saccharomyces cerevisiae antibodies [ASCA] IgA/IgG, anti-OmpC, anti-CBir1, anti-A4-Fla2, anti-Fla-X) and titer were tested. Quartile sum score (range 6-24), logistic regression analysis, and correlation with phenotype, smoking status, and endoscopic outcome were assessed. RESULTS: Patients with ≥ 2 previous resections were more likely to be anti-OmpC positive (94% vs 55%, ≥ 2 vs < 2, P = 0.001). Recurrence at 18 months was associated with anti-Fla-X positivity at baseline (49% vs 29%; positive vs negative, P = 0.033) and 12 months (52% vs 31%, P = 0.04). Patients positive (n = 28) for all four antibacterial antibodies (anti-CBir1, anti-OmpC, anti-A4-Fla2, and anti-Fla-X) at baseline were more likely to experience recurrence at 18 months than patients negative (n = 32) for all four antibodies (82% vs 18%, P = 0.034; odds ratio 6.4, 95% confidence interval 1.16-34.9). The baseline quartile sum score for all six antimicrobial antibodies was higher in patients with severe recurrence (Rutgeert's i3-i4) at 18 months, adjusted for clinical risk factors (odds ratio 1.16, 95% confidence interval 1.01-1.34, P = 0.039). Smoking affected antibody status. CONCLUSIONS: Anti-Fla-X and presence of all anti-bacterial antibodies identifies patients at higher risk of early postoperative Crohn's disease recurrence. Serologic screening pre-operatively may help identify patients at increased risk of recurrence.
BACKGROUND AND AIM: Disease recurs frequently after Crohn's disease resection. The role of serological antimicrobial antibodies in predicting recurrence or as a marker of recurrence has not been well defined. METHODS: A total of 169 patients (523 samples) were prospectively studied, with testing peri-operatively, and 6, 12 and 18 months postoperatively. Colonoscopy was performed at 18 months postoperatively. Serologic antibody presence (perinuclear anti-neutrophil cytoplasmic antibody [pANCA], anti-Saccharomyces cerevisiae antibodies [ASCA] IgA/IgG, anti-OmpC, anti-CBir1, anti-A4-Fla2, anti-Fla-X) and titer were tested. Quartile sum score (range 6-24), logistic regression analysis, and correlation with phenotype, smoking status, and endoscopic outcome were assessed. RESULTS:Patients with ≥ 2 previous resections were more likely to be anti-OmpC positive (94% vs 55%, ≥ 2 vs < 2, P = 0.001). Recurrence at 18 months was associated with anti-Fla-X positivity at baseline (49% vs 29%; positive vs negative, P = 0.033) and 12 months (52% vs 31%, P = 0.04). Patients positive (n = 28) for all four antibacterial antibodies (anti-CBir1, anti-OmpC, anti-A4-Fla2, and anti-Fla-X) at baseline were more likely to experience recurrence at 18 months than patients negative (n = 32) for all four antibodies (82% vs 18%, P = 0.034; odds ratio 6.4, 95% confidence interval 1.16-34.9). The baseline quartile sum score for all six antimicrobial antibodies was higher in patients with severe recurrence (Rutgeert's i3-i4) at 18 months, adjusted for clinical risk factors (odds ratio 1.16, 95% confidence interval 1.01-1.34, P = 0.039). Smoking affected antibody status. CONCLUSIONS: Anti-Fla-X and presence of all anti-bacterial antibodies identifies patients at higher risk of early postoperative Crohn's disease recurrence. Serologic screening pre-operatively may help identify patients at increased risk of recurrence.
Authors: Ashley E Landuyt; Barbara J Klocke; Lennard W Duck; Keri M Kemp; Rachel Q Muir; Melissa S Jennings; Samuel I Blum; Hubert M Tse; Goo Lee; Casey D Morrow; Charles O Elson; Craig L Maynard Journal: Proc Natl Acad Sci U S A Date: 2021-03-30 Impact factor: 11.205
Authors: B Sensi; L Siragusa; C Efrati; L Petagna; M Franceschilli; V Bellato; A Antonelli; C Arcudi; M Campanelli; S Ingallinella; A M Guida; A Divizia Journal: J Immunol Res Date: 2020-12-26 Impact factor: 4.818
Authors: Serena Longo; Marcello Chieppa; Luca G Cossa; Chiara C Spinelli; Marco Greco; Michele Maffia; Anna M Giudetti Journal: Proteomes Date: 2020-08-10