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Assessment of clinical activity and severity using serum ANCA and ASCA antibodies in patients with ulcerative colitis.
Allergy, Asthma & Clinical Immunology ( IF 2.6 ) Pub Date : 2020-05-20 , DOI: 10.1186/s13223-020-00433-1
Yanhua Pang 1 , Huijie Ruan 2 , Dongfang Wu 3 , Yanfei Lang 2 , Ke Sun 4 , Cuiping Xu 2
Affiliation  

Ulcerative colitis (UC) is a chronic, non-specific inflammatory bowel disease (IBD) with unknown etiology. The lack of specific clinical manifestations, standard diagnostic criteria, objective and accurate indicators to the severity of the disease and the efficacy of the treatment, often results in difficulties in diagnosis and timely treatment of UC. Therefore, there is a need to develop a clinically suitable serum biomarker assay with high specificity and sensitivity. To explore the significance of anti-neutrophil cytoplasmic antibodies (ANCA) and anti-saccharomyces cerevisiae antibodies (ASCA) in the diagnosis, differential diagnosis and treatment assessment in patients with ulcerative colitis (UC). Serum levels of ANCA-IgG, ASCA-IgA and ASCA-IgG were measured by an enzyme-linked immunosorbent assay (ELISA) in 105 UC patients, 52 non-UC patients and 100 healthy controls. (1) Both the ANCA-IgG level and its positive rate in UC patients were significantly higher than those in non-UC controls and healthy controls (p < 0.01). However, the levels of ASCA-IgA, ASCA-IgG and the positive rates in UC patients had no statistical differences when compared with those in non-UC controls or healthy controls (p > 0.05). (2) The sensitivity of ANCA+ and ANCA+/ASCA− in detecting UC patients was 61.90% and 55.24%, respectively, whereas the specificity was 91.45% and 94.08%, respectively. The sensitivity of ASCA+ and ASCA+/ANCA− in non-UC disease controls was 5.33% and 3.85%, respectively, and specificity was 83.9% and 88.78%, respectively. (3) When UC patients were grouped into mild, moderate or severe subtypes, the ANCA-IgG levels were correlated with the severity of UC, and the differences of the ANCA-IgG levels were statistically different among the three subtypes (p < 0.05). There was no correlation between the levels of ANCA-IgG and the disease locations of UC. (1) Serum levels of ANCA may be useful in the diagnosis of UC. (2) Dynamic quantitation of ANCA-IgG levels may be helpful in determining the severity of UC and therefore, may guide treatment of UC.

中文翻译:

在溃疡性结肠炎患者中使用血清 ANCA 和 ASCA 抗体评估临床活动和严重程度。

溃疡性结肠炎 (UC) 是一种病因不明的慢性非特异性炎症性肠病 (IBD)。UC缺乏具体的临床表现、标准的诊断标准、客观准确的疾病严重程度和治疗效果指标,往往给UC的诊断和及时治疗带来困难。因此,需要开发具有高特异性和灵敏度的临床适用的血清生物标志物测定。探讨抗中性粒细胞胞浆抗体(ANCA)和抗酿酒酵母抗体(ASCA)在溃疡性结肠炎(UC)患者诊断、鉴别诊断和治疗评估中的意义。通过酶联免疫吸附试验 (ELISA) 在 105 名 UC 患者中测量了 ANCA-IgG、ASCA-IgA 和 ASCA-IgG 的血清水平,52 名非 UC 患者和 100 名健康对照。(1)UC患者的ANCA-IgG水平及其阳性率均显着高于非UC对照和健康对照(p<0.01)。但UC患者ASCA-IgA、ASCA-IgG水平及阳性率与非UC对照或健康对照相比无统计学差异(p>0.05)。(2)ANCA+和ANCA+/ASCA-检测UC患者的敏感性分别为61.90%和55.24%,特异性分别为91.45%和94.08%。ASCA+ 和 ASCA+/ANCA- 在非 UC 疾病对照中的敏感性分别为 5.33% 和 3.85%,特异性分别为 83.9% 和 88.78%。(3)将UC患者分为轻度、中度或重度亚型时,ANCA-IgG水平与UC严重程度相关,ANCA-IgG水平在三个亚型间差异有统计学意义(p < 0.05)。ANCA-IgG水平与UC病灶无相关性。(1) 血清 ANCA 水平可能有助于 UC 的诊断。(2) ANCA-IgG 水平的动态定量可能有助于确定 UC 的严重程度,因此可以指导 UC 的治疗。
更新日期:2020-05-20
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