Significance of anti-sacharomices cerevisiae antibodies (ASCA) in patients with inflammatory bowel diseases in Romania

Abstract

Introduction. Anti- Sacharomyces cerevisiae antibodies (ASCA) represent the immunologic marker correlated with Crohn’s disease because of their high specificity (80-95%). The aim of this study is to confirm their value in a Romanian population with IBD.

Material and methods. A prospective longitudinal study was performed, which included patients admitted to Center of Gastroenterology and Hepatology Fundeni, Bucharest, in 2000 with ulcerative colitis (33 patients) - UC group, or Crohn’s disease (40 patients) - CD group, and a control group (C) consisting of 22 healthy subjects. ASCA determination from serum samples was performed in the Erasmus University by ELISA technique.

Results. ASCA+ prevalence in CD group was 5 in 40 patients (12.5%), in UC group 0/33 (0%), 1/21 C group (4.9%), p= 0.05. ASCA+ phenotype was found only in patients with CD diagnosed before the age of 40 years (A1), p=0.04. Also, ASCA+ phenotype correlated significantly with the colonic (L2) or ileocolonic (L3) extension (p=0.05). ASCA+ status did not correlate with the evolutive pattern of CD (stricturing, penetrating or non- stricturing non- penetrating), and neither did the clinical severity.

Conclusions. ASCA+ prevalence in CD patients is much lower compared with North-American or West-European studies (12.5% versus 40-70%). In Romanian patients, ASCA assessment may be helpful in achieving a diagnosis of Crohn’s disease, especially in those younger than 40 years, or in those with colonic or ileocolonic extension.