P704. Do antiglycan antibodies have an impact on the course of Crohn's disease?
S. Kaymakoglu1, A. Ormeci1, O. Mutluay Soyer1, B. Baran1, S. Gokturk1, S. Evirgen1, F. Akyüz1, C. Karaca1, K. Demir1, F. Besisik1, N. Gürel polat2, 1Istanbul university, Gastroenterology, Istanbul, Turkey, 2Istanbul university, Microbiology, Istanbul, Turkey
Antiglycan antibodies have an impact on the need for surgical intervention associated with Crohn's disease (CD) and development of CD-related complications.
Serum samples were obtained from 151 patients with a diagnosis of CD during 1990–2011. Demographic characteristics, type of disease (initial and follow-up), development of CD related complications (fistule, abcess, stenosis), requirement for surgical intervention and presence of extraintestinal manifestation (EIM) were determined. Anti-laminarin IgA (Anti-L), anti-chitin IgA (Anti-C), anti-mannobioside IgG (AMCA) and anti-Saccharomyces cerevisiae IgG (gASCA) antibodies (Glycominds, Lod, Israel) were evaluated by ELISA, p ANCA was determined by immunofluorescence method.
Mean age of patients 36±11 (18–72) years, 47.7% were male and follow-up duration was 36±42 months. Early onset of disease (<40 years of age) was found in 74% of cases. Development of complications and need for surgical operation related to CD among all patients was 48% and 34.4%, respectively. Rate of EIM was determined 20%. Positivity of anti-L, anti-C, gASCA and AMCA was 30.5%, 38.4%, 38% and 38.4%, respectively.pANCA was positive in only 3 patients. Positivity of any single antibody was determined as 34%, of any two antibodies as 27.8%, any three antibodies as 7.9% and any four antibodies as 4.9%. A linear correlation was found between presence of more than one antibody and the need for surgery and development of complications, though the correlation did not reach a statistically significant level. A statistically significant correlation was determined between anti-L positivity and development of complications (p = 0.03, OR = 2.95% Cl 1.9–4.1). In addition, a significant correlation was present between ASCA positivity and need for surgical operation (p = 0.03 R = 0.264) and development of complications (p = 0.03 R = 0.22). No correlation was found between presence of anti-C and AMCA antibodies and development of complications and the need for surgery. No correlation was seen between presence of EIM and positivity of any single antibody. Rate of anti-L positivity among patients with inflammatory disease at initial stage, progressing with fistulizing type (n: 19) was 52.6% and was significantly higher as compared to cases progressing with inflammatory type of disease (22%) or obstructive disease (40%) (p = 0.03).
CD follows a more aggressive course in patients with anti-L and ASCA positivity; rate of complications and need for surgical intervention is increased in such patients.