Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/16987
Title: Serologic antibodies in relation to outcome in postoperative Crohn's disease
Austin Authors: Hamilton, Amy L;Kamm, Michael A;De Cruz, Peter;Wright, Emily K;Selvaraj, Fabiyola;Princen, Fred;Gorelik, Alexandra;Liew, Danny;Lawrance, Ian C;Andrews, Jane M;Bampton, Peter A;Sparrow, Miles P;Florin, Timothy H;Gibson, Peter R;Debinski, Henry;Gearry, Richard B;Macrae, Finlay A;Leong, Rupert W;Kronborg, Ian;Radford-Smith, Graham;Selby, Warwick;Bell, Sally J;Brown, Steven J;Connell, William R
Affiliation: Department of Gastroenterology, St Vincent's Hospital, Melbourne, Victoria, Australia
Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
Austin Health, Heidelberg, Victoria, Australia
Prometheus Laboratories, San Diego, California, USA
Melbourne EpiCentre, University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia
Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
Centre for Inflammatory Bowel Diseases, Saint John of God Hospital, Subiaco, Western Australia, Australia
Harry Perkins Institute for Medical Research, Nedlands, Western Australia, Australia
Fiona Stanley Hospital, Perth, Western Australia, Australia
Department of Gastroenterology and Hepatology, University of Adelaide, Adelaide, South Australia, Australia
Royal Adelaide Hospital, Adelaide, South Australia, Australia
Department of Gastroenterology and Hepatology, Flinders Medical Centre and Flinders University, Adelaide, South Australia, Australia
Department of Gastroenterology, Alfred Health, Melbourne, Victoria, Australia
Immunity Infection and Inflammation Program, Mater Research Institute-University of Queensland, and School of Medicine, University of Queensland, Brisbane, Queensland, Australia
Translational Research Institute, Woolloongabba, Queensland, Australia
Department of Gastroenterology, Monash University, Melbourne, Victoria, Australia
Melbourne Gastrointestinal Investigation Unit, Cabrini Hospital, Melbourne, Victoria, Australia
Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
Department of Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
Gastroenterology and Liver Services, Concord and Bankstown Hospitals and University of New South Wales, Sydney, New South Wales, Australia
Department of Gastroenterology, Western Hospital, Melbourne, Victoria, Australia
Department of Gastroenterology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
IBD Group Queensland Institute of Medical Research, University of Queensland, Brisbane, Queensland, Australia
AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
Issue Date: Jun-2017
metadata.dc.date: 2017-05-30
Publication information: Journal of Gastroenterology and Hepatology 2017; 32(6): 1195-1203
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.
URI: http://ahro.austin.org.au/austinjspui/handle/1/16987
DOI: 10.1111/jgh.13677
PubMed URL: https://pubmed.ncbi.nlm.nih.gov/27976801
Type: Journal Article
Subjects: Crohn's disease
antibodies
postoperative
serology
smoking
Appears in Collections:Journal articles

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