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* = Presenting author

P086. Clinical utility of anti-glycan antibodies in pediatric Crohn's disease in comparison with an adult cohort

F. Rieder1, P. Hahn2, L. Finsterholzl2, A. Dirmeier2, B. Shen1, G. Rogler3, F. Klebl2, T. Lang2

1Cleveland Clinic Foundation, Cleveland, OH, United States; 2University of Regensburg, Regensburg, Germany; 3University of Zurich, Zurich, Germany

Aims: We tested a panel of serological anti-glycan antibodies including the novel anti-laminarin IgA (Anti-L) and anti-chitin IgA (Anti-C) carbohydrate antibodies in pediatric Crohn's disease (CD) patients for diagnosis, differential diagnosis of CD and association with complicated CD behavior. In addition we compared the serologic panel in pediatric CD with adult CD patients for possible changes in accuracy over time.

Materials and Methods: The presence of Anti-L, Anti-C, anti-chitobioside IgA (ACCA), anti-laminaribioside IgG (ALCA), anti-mannobioside IgG (AMCA) and anti-Saccaromyces cervisiae IgG (gASCA) carbohydrate antibodies were tested in serum samples of 131 pediatric participants (59 CD, 27 ulcerative colitis (UC), and 45 non-inflammatory bowel disease (IBD) controls) with ELISA. Results were compared to an adult cohort of 728 participants (355 CD, 129 ulcerative colitis (UC), and 244 non-IBD controls).

Results: 78% of the pediatric CD patients were positive for at least one of the anti-glycan antibodies. gASCA was most accurate for the diagnosis of CD, but combined use of the antibodies improved differentiation of CD from UC. gASCA, AMCA, ALCA or Anti-L as well as an increasing antibody level were independently linked to complicated CD behavior, CD-related surgery and ileal disease location (Odds ratio 3.9–8.7). This was observed for both quantitative and qualitative antibody responses. When the age at sample procurement was considered the accuracy of the markers compared to an adult cohort remained stable for the differentiation of CD versus UC as well as for the association with complications, CD related surgery and ileal disease involvement.

Conclusion: A panel of anti-glycan antibodies including the novel Anti-L and Anti-C may aid in differentiation of pediatric CD from UC and is associated with complicated CD behavior. The accuracy of the markers over time remained constant.