Title |
Serologic antibodies in relation to outcome in postoperative Crohn's disease
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Published in |
Journal of Gastroenterology & Hepatology, May 2017
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DOI | 10.1111/jgh.13677 |
Pubmed ID | |
Authors |
Amy L Hamilton, Michael A Kamm, Peter De Cruz, Emily K Wright, Fabiyola Selvaraj, Fred Princen, Alexandra Gorelik, Danny Liew, Ian C Lawrance, Jane M Andrews, Peter A Bampton, Miles P Sparrow, Timothy H Florin, Peter R Gibson, Henry Debinski, Richard B Gearry, Finlay A Macrae, Rupert W Leong, Ian Kronborg, Graham Radford‐Smith, Warwick Selby, Sally J Bell, Steven J Brown, William R Connell |
Abstract |
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. 169 patients (523 samples) were prospectively studied, with testing peri-operatively, and 6, 12 and 18 months post-operatively. Colonoscopy was performed at 18 months post-operatively. Serologic antibody presence (pANCA, ASCA IgA/IgG, anti-OmpC, anti-CBir1, anti-A4-Fla2, anti-Fla-X) and titre were tested. Quartile sum score (range 6-24), logistic regression analysis, and correlation with phenotype, smoking status and endoscopic outcome were assessed. Patients with ≥2 previous resections were more likely to be anti-OmpC positive (94% vs. 55%, ≥2 v <2, P = 0.001). Recurrence at 18 months was associated with anti-Fla-X positivity at baseline (49% v 29%; positive v negative, P = 0.033) and 12 months (52% v 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% v 18%, P = 0.034; OR 6.4, 95% CI 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 (OR 1.16, 95% CI 1.01-1.34, P = 0.039). Smoking affected antibody status. Anti-Fla-X and presence of all anti-bacterial antibodies identifies patients at higher risk of early post-operative Crohn's disease recurrence. Serologic screening pre-operatively may help identify patients at increased risk of recurrence. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 1 | 50% |
Unknown | 1 | 50% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 2 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 59 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Ph. D. Student | 11 | 19% |
Student > Master | 6 | 10% |
Student > Bachelor | 6 | 10% |
Researcher | 5 | 8% |
Student > Postgraduate | 5 | 8% |
Other | 9 | 15% |
Unknown | 17 | 29% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 27 | 46% |
Biochemistry, Genetics and Molecular Biology | 3 | 5% |
Agricultural and Biological Sciences | 3 | 5% |
Pharmacology, Toxicology and Pharmaceutical Science | 1 | 2% |
Nursing and Health Professions | 1 | 2% |
Other | 4 | 7% |
Unknown | 20 | 34% |