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P195. Mannose-binding lectin deficiency is not associated with anti-Saccharomyces cerevisiae antibody in Korean Crohn's disease patients

Y.S. Kim1, Y.-H. Kim2, B.D. Ye3, J.W. Kim4, D.S. Han5, 1Inje University, Internal Medicine, Seoul, South Korea, 2Sungkyunkwan University School of Medicine, South Korea, 3University of Ulsan College of Medicine, South Korea, 4Seoul National University College of Medicine, South Korea, 5Hanyang University College of Medicine, South Korea

Background

Mannose-binding lectin (MBL) is a soluble pattern-recognition molecule and an important component of the innate host defense mechanism. Anti-Saccharomyces cerevisiae antibody (ASCA) is a well known serologic marker of Crohn's disease (CD) and it is associated with severe clinical presentations. However, the relationship between the ASCA and MBL deficiency is controversial in patients with CD. The aim of this study is to investigate the serum MBL level, the prevalence of MBL deficiency and the relationship between ASCA and MBL deficiency in Korean CD patients. We also investigate the ASCA positivity and clinical manifestations in Korean CD patients.

Methods

Two hundred eighty-three well-characterized CD patients (male 215; age 34.2±10.8 years) were included. MBL levels were measured by ELISA (R&D Systems. Minneapolis. MN, USA). Both serum IgG and IgA levels of ASCA were determined by ELISA (QUANTA Lite TM, INOVA Diagnostics, San Diego, CA). The absolute MBL deficiency and low MBL level were defined when serum MBL levels were below than 100 or 500 ng/mL, respectively.

Results

Absolute MBL deficiency was noted in only one CD patient (0.4%). Low MBL levels were observed in 54 patients with CD (18.1%) and in 9 patients in the control group (30%) (p = 0.096). MBL levels showed no difference according to age at the diagnosis (p = 0.84), behavior (p = 0.20) or the location (p = 0.63) of patients with CD. ASCA positivity in CD patients was 48.1% (136/283), which was significantly higher than the control (6.7%) (p < 0.01). MBL levels (p = 0.49) and the frequency of low MBL levels (p = 0.133) showed no difference according to ASCA positivity. In addition, ASCA IgG and MBL levels showed no correlation (p = 0.89). ASCA positive CD patients showed more presence of perianal fistula (77/136, 56.6% vs. 65/147, 44.2%; p = 0.043), younger age at the diagnosis (25.2±8.27 vs. 28.1±11.87; p = 0.021) and frequent intestinal surgery (62/136, 45.6% vs. 50/147, 34.0%; p = 0.047) than ASCA negative CD patients.

Conclusion

MBL deficiency is very rare in Korean CD patients. MBL level has no association with clinical features of CD patients. Moreover, the frequency of low MBL level has no association with ASCA positivity. ASCA positivity is associated with the presence of perianal fistula, younger age at diagnosis and history of intestinal surgery, which suggests for a more severe clinical course in Korean CD patients.