OBJECTIVES Anti-cytolethal distending toxin B (CdtB) and anti-vinculin antibodies have been proposed as biomarkers that discriminate irritable bowel syndrome (IBS) diarrhea from inflammatory bowel disease; however, it is unknown whether they can also discriminate patients with IBS and IBS subtypes and functional dyspepsia (FD) from healthy individuals in the general population. We aimed to determine whether anti-CdtB and anti-vinculin can discriminate IBS and FD from health and from organic gastrointestinal (GI) disease. METHODS Adults were enrolled from 2 Australian studies: (i) a random, population-based study (n = 331) with subjects diagnosed with IBS (n = 63) or FD (n = 61) by modified Rome III criteria or healthy control subjects (n = 246) who did not meet criteria for IBS and/or FD and (ii) an outpatient-based study with subjects diagnosed with IBS (n = 256) and/or FD (n = 55) or organic GI disease (n = 182) by an independent clinician. Serum levels of anti-CdtB/anti-vinculin antibodies were determined by enzyme-linked immunosorbent assay. RESULTS There was a significantly higher mean value of anti-CdtB in FD vs healthy controls (mean = 2.46 [SD = 0.72] vs mean = 2.14 [SD = 0.77]; P = 0.005) and IBS/FD overlap vs healthy controls (mean = 2.47 [SD = 0.78] vs mean = 2.14 [SD = 0.77]; P = 0.02). There were no significant differences in anti-CdtB in IBS and FD outpatients or IBS/FD subgroups compared with patients with organic GI disease. In terms of anti-vinculin, there were no significant differences between IBS and FD and healthy controls or between IBS and FD and organic GI disease controls. DISCUSSION We did not confirm that anti-CdtB/anti-vinculin discriminated IBS diarrhea from organic GI disease in Australian subjects. However, we did find higher anti-CdtB in FD and IBS/FD overlap vs healthy controls. Postinfectious FD may be more common than currently recognized.

中文翻译：

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在具有功能性消化不良和肠易激综合症的社区和医疗保健人群中，循环抗细胞致死性毒素B和抗Vinculin抗体作为生物标记。

目的已提出抗细胞致死性扩张毒素B（CdtB）和抗Vinculin抗体作为区分肠易激综合征（IBS）腹泻与炎性肠病的生物标志物。然而，尚不清楚他们是否还能将IBS和IBS亚型和功能性消化不良（FD）的患者与普通人群中的健康个体区分开。我们旨在确定抗CdtB和抗Vinculin是否能将IBS和FD与健康和有机胃肠道（GI）疾病区分开。方法从2项澳大利亚研究中纳入了成年人：（i）随机，人群为基础的研究（n = 331），其受试者通过改良的罗马III标准诊断为IBS（n = 63）或FD（n = 61），或健康对照受试者（n = 246）不符合IBS和/或FD和（ii）由独立临床医生诊断为IBS（n = 256）和/或FD（n = 55）或器质性胃肠疾病（n = 182）的受试者为基础的门诊研究。通过酶联免疫吸附测定法测定抗CdtB /抗vinculin抗体的血清水平。结果FD与健康对照组相比，抗CdtB的平均值显着较高（平均值= 2.46 [SD = 0.72] vs平均值= 2.14 [SD = 0.77]； P = 0.005），并且IBS / FD重叠相对于健康对照组（平均值= 2.47 [SD = 0.78] vs平均值= 2.14 [SD = 0.77]； P = 0.02）。与器质性GI疾病患者相比，IBS和FD门诊患者或IBS / FD亚组的抗CdtB无显着差异。在抗长春花碱方面，IBS和FD与健康对照之间或IBS与FD与器质性GI疾病对照之间无显着差异。讨论我们并未证实抗CdtB /抗Vinculin可以将IBS腹泻与澳大利亚受试者的有机胃肠疾病区分开。但是，我们确实发现FD和IBS / FD重叠中的抗CdtB高于健康对照。感染后FD可能比目前公认的更为普遍。讨论我们并未证实抗CdtB /抗Vinculin可以将IBS腹泻与澳大利亚受试者的有机胃肠疾病区分开。但是，我们确实发现FD和IBS / FD重叠中的抗CdtB高于健康对照。感染后FD可能比目前公认的更为普遍。讨论我们并未证实抗CdtB /抗Vinculin可以将IBS腹泻与澳大利亚受试者的有机胃肠疾病区分开。但是，我们确实发现FD和IBS / FD重叠中的抗CdtB高于健康对照。感染后FD可能比目前公认的更为普遍。