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P107. Serological markers can predict inflammatory bowel disease years before the diagnosis: Results from a nested case–control study within a European cohort study

F. van Schaik1, B. Oldenburg2, A. Hart3, P. Siersema4, M. Van Oijen4, B. Bueno-de-Mesquita5

1University Medical Center Utrecht, Gastroenterology and hepatology, Utrecht, Netherlands; 2University Medical Centre Utrecht, Department of Gastroenterology, Utrecht, Netherlands; 3University of East Anglia, Health Policy and Practice/School of Medicine, Norwich, United Kingdom; 4University Medical Center Utrecht, Department of Gastroenterology and Hepatology, Utrecht, Netherlands; 5Center for Nutrition and Health, National Institue of Public Health and the Environment, Bilthoven, the Netherlands, Netherlands

Background: Anti-neutrophil cytoplasmic antibodies (ANCAs) and several antimicrobial antibodies have been detected in serum of patients with ulcerative colitis (UC) and Crohn's disease (CD). The aim of this study was to assess the prevalence of five serological markers in individuals years before the UC or CD diagnosis, and establish their value as predictors of UC or CD.

Methods: Individuals that developed CD or UC were identified from the European Prospective Investigation into Cancer and Nutrition (EPIC) database. At recruitment into this study, none of the participants had a diagnosis or symptoms suggestive of CD or UC. For each incident case of UC and CD two controls were randomly selected and matched for participating center, date of birth, gender and date of recruitment into EPIC. Sera of cases and controls were obtained at recruitment and analysed for anti-Saccharomyces cerevisiae mannan (ASCA) IgG and IgA, pANCA, antibodies against Escherichia coli outer membrane porin C (OmpC) and against the flagellin CBir1. Conditional logistic regression was used to determine risk of CD and UC. Receiver operating characteristics (ROC) curves were constructed to test the accuracy of individual serological markers and a combination of them.

Results: A total of 77 individuals developed CD and 167 UC. Individuals developed CD and UC a mean of 4.5 (SD 3.2) and 4.4 (SD 3.1) years after serum sampling, respectively. A combination of pANCA, ASCA, anti-CBir1 and anti-OmpC predicted incident CD and UC cases most accurately (AUC 0.679 and 0.657, respectively). Risk of developing CD or UC using the combination of markers significantly increased when time to development of CD or UC decreased.

Conclusions: This study shows that a combination of serological markers can be used as screening test for future development of CD and UC.