Serological antibodies in inflammatory bowel disease: A systematic review

Authors

  • Lani Prideaux MD,

    1. Department of Gastroenterology, St Vincent's Hospital Melbourne, Australia
    2. The University of Melbourne, Melbourne, Australia
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  • Peter De Cruz MD,

    1. Department of Gastroenterology, St Vincent's Hospital Melbourne, Australia
    2. The University of Melbourne, Melbourne, Australia
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  • Siew C. Ng MD, PhD,

    1. Department of Gastroenterology, St Vincent's Hospital Melbourne, Australia
    2. The University of Melbourne, Melbourne, Australia
    3. Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong
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  • Michael A. Kamm MD, PhD

    Corresponding author
    1. Department of Gastroenterology, St Vincent's Hospital Melbourne, Australia
    2. The University of Melbourne, Melbourne, Australia
    • St Vincent's Hospital, Victoria Parade, Fitzroy, 3065, Melbourne, Australia
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Abstract

The diagnosis of inflammatory bowel disease (IBD) is traditionally based on a combination of clinical, endoscopic, histological, and radiological criteria. However, further testing is needed in cases of diagnostic uncertainty and in predicting disease course. This systematic review focuses on the potential for 10 serological antibodies to fill these roles: pANCA, ASCA, anti-OmpC, anti-CBir1, anti-I2, ALCA, ACCA, AMCA, anti-L, and anti-C. We discuss their prevalence in IBD and health; their role in disease diagnosis and risk stratification; their stability over time; their presence in unaffected relatives; their association with genetic variants; and differences across ethnic groups. Serological antibodies have some role in primary diagnosis and in differentiating between Crohn's disease and ulcerative colitis. In indeterminate colitis, preoperative measurement of serological antibodies can help to predict the likelihood of complications among patients undergoing pouch surgery. The combined presence and magnitude of a large panel of antibodies appear to be of value in predicting disease progression. There is currently insufficient evidence to recommend the use of antibody testing to predict responses to treatment or surgery in patients with IBD. (Inflamm Bowel Dis 2011;)

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